Dr. Wendy Oliver-Pyatt, Chevese Turner, and the Eating Disorders Education Institute (“EDEI”) are aggressively promoting EDCS to clinicians as a professional credential reflecting specialized eating disorder knowledge, clinical readiness and professional development. EDEI wants clinicians to spend thousands of dollars obtaining the designation and then place the initials after their names, where employers, referral sources, patients and families may reasonably interpret them as evidence of specialized competence. A credential intended to carry that kind of professional significance necessarily depends upon trust in both the credential and the organization issuing it.

That trust should not be difficult to establish if EDEI has built what it claims to have built. Yet serious questions have repeatedly been raised concerning the meaning and validation of EDCS, EDEI’s ownership and financial independence, the manner in which insiders obtained the credential before general availability, EDEI’s extensive connections with Within Health, the authority exercised by its President Ms. Turner, and whether Ms. Turner’s openly political philosophy can be separated from a credentialing process that includes subjective evaluation of clinicians. Some of these questions have previously been asked. Meaningful answers have not followed.

The following questions are not demands that Dr. Oliver-Pyatt or Ms. Turner agree with their critics. Most of the questions concern facts almost entirely within EDEI’s possession, including its ownership, financing, standards, validation, scoring, conflicts, credentialing files and governance. An organization asking to evaluate the competence and judgment of other professionals should be willing to permit meaningful scrutiny of its own competence, judgment and independence.

So, the inquiry can be reduced to fifteen fundamental questions.

1. What, precisely does EDCS establish?

EDEI has described EDCS in terms suggesting specialized knowledge, clinical readiness, mastery and applied clinical skill, while also using language disclaiming any guarantee of clinical competence or expert-level status. Those propositions need to be reconciled because patients and employers will not parse the legal nuances of EDEI’s website. When a clinician places EDCS after a name, what exactly does EDEI represent that those four letters establish, and what should a patient, employer or referral source reasonably understand them to mean?

2. Who independently recognizes EDEI’s authority to determine who qualifies as an eating disorder specialist?

EDEI created EDCS and now asks an established professional community to recognize the resulting designation. Has any independent medical specialty board, state licensing authority, university, established credentialing organization or independent accrediting body reviewed the finished program and formally recognized EDCS as a valid measure of specialized eating disorder competence? If no such organization has done so, EDEI should explain the basis upon which it believes the field should confer that authority upon EDEI itself.

3. What exactly did the Delphi process validate?

Dr. Oliver-Pyatt has described EDEI’s Delphi study as identifying 157 priority areas “to guide the curriculum.” Identifying subjects that experts believe should be taught is not necessarily the same thing as validating the curriculum subsequently written, the examination, a passing score, the live practicum or the finished professional credential. EDEI should identify precisely what the Delphi process established and explain the scientific basis for describing the resulting program or credential as “Delphi-validated.”

4. Where is the independent psychometric validation of EDCS?

A professional credential intended to distinguish specialist competence ordinarily requires defensible methods for identifying competencies, constructing assessments, establishing passing standards and determining whether the instrument reliably measures what the organization says it measures. Did EDEI conduct a formal job-task or competency analysis, examination validation, cut-score study, reliability analysis, item-discrimination analysis or comparable psychometric work? If so, EDEI should identify the independent experts who performed that work and publish sufficient results to permit the profession to evaluate the credential’s validity.

5. Why have EDEI’s published requirements for the same credential conflicted?

EDEI materials have described different numbers of required courses and different numbers of live practicum hours for apparently identical EDCS pathways. That is not an insignificant typographical issue when live practicum is promoted as a distinguishing feature demonstrating applied clinical ability. EDEI should state the actual requirements, explain when and why they changed, and identify which requirements were applied to every individual who obtained EDCS before the program became generally available.

6. If live practicum demonstrates clinical readiness, why can some applicants receive the same EDCS designation without completing it?

EDEI has emphasized practicum as a feature distinguishing its program from ordinary continuing education, yet its Direct pathway permits qualifying professionals to receive the same EDCS designation without completing the ordinary live-practicum requirement. If practicum is necessary to establish applied competence for one clinician, EDEI should explain why it is unnecessary for another clinician receiving precisely the same letters and what evidence demonstrates that the two pathways produce equivalent credential holders.

7. How did Dr. Oliver-Pyatt, EDEI instructors and other insiders obtain EDCS before ordinary clinicians could complete the publicly advertised program?

This should have an exceptionally simple documentary answer. EDEI can identify the courses completed by each pre-launch credential holder, examinations or assessments taken, practicum requirements satisfied, evaluator involved, passing standard applied, fees paid, waivers granted and person or independent authority who approved the credential. If insiders received substantially different treatment from the clinicians now being asked to purchase EDCS, the profession deserves to know that before assigning meaning to the designation.

8. Who owns EDEI, who financed its development and what does Turner’s representation that it was built entirely “out of pocket” actually mean?

Ms. Turner publicly stated that EDEI has no corporate owner, no outside investors, no venture capital funding and that its founders “did it all ourselves out of pocket.” That statement is factual and readily verifiable. EDEI should identify every owner of the entity through which it operates, every ownership percentage, every capital contribution and loan, and every affiliated organization that supplied employees, technology, marketing, legal work, administration, intellectual property, course development or other services of value.

9. What resources, personnel or services has Within Health supplied to EDEI?

Dr. Oliver-Pyatt leads both EDEI and Within Health, Ms. Turner has previously been identified as a Within advisor, and current Within clinical personnel teach through EDEI. The significant question is therefore not whether the entities have different legal names but how separate they are operationally. EDEI should disclose whether Within has provided compensated employee time, technology, administrative services, marketing, curriculum assistance, professional contacts, software, intellectual property or other resources, and whether EDEI pays fair value for any such assistance.

10. Who financially benefits if EDCS becomes widely accepted?

EDEI is a commercial enterprise charging substantial amounts for credentialing pathways, and the value of the business necessarily increases if EDCS becomes recognized by clinicians, employers, treatment organizations and patients. EDEI should disclose its projected enrollment, revenues and renewal income, identify the individuals entitled to profits, and explain whether affiliated treatment companies stand to obtain additional professional or commercial benefits when their clinicians display a credential created by an organization connected to the same founder.

11. What did Chevese Turner mean when she said this work is “very political” and that “there is no room for neutrality”?

Ms. Turner has described the work as “social justice, rooted in policy, very political” and said there is “no room for neutrality.” Those words require explanation when the speaker is not merely an activist participating in the program but the President of an organization proposing to evaluate licensed professionals. EDEI should state whether Ms. Turner’s description represents its institutional philosophy and identify precisely whether political or social-justice concepts influence curriculum requirements, practicum scoring, candidate evaluation or credentialing decisions.

12. Can a clinically competent applicant reject HAES, weight neutrality, body liberation, intersectionality or social-justice theory and still receive EDCS?

The issue is not whether clinicians should understand these frameworks. A professional may understand a theory thoroughly while disagreeing with its premises or rejecting it as the governing framework for patient care. EDEI should state unequivocally whether a clinician can disagree with Ms. Turner and EDEI concerning these contested approaches and nevertheless earn EDCS solely by demonstrating defensible medical, psychological or nutritional competence. If the answer is yes, that protection should appear expressly in EDEI’s written credentialing rules.

13. What actual authority does Turner possess over clinicians seeking EDCS?

EDEI has described Ms. Turner as leading efforts to educate and credential providers, but the limits of her authority have not been made sufficiently clear. EDEI should disclose whether Turner can approve curriculum, select instructors or practicum evaluators, see candidate identities, review candidate assessments, influence passing decisions, participate in appeals, investigate complaints, modify credentialing requirements or participate in credential revocation. That information becomes especially important given Ms. Turner’s extensive public record of political advocacy, distrust of aspects of the medical establishment and confrontational treatment of some people she regarded as professional adversaries.

14. What independent safeguards protect applicants from evaluator bias?

A live practicum necessarily involves judgment, and subjective judgment creates the possibility of conscious or unconscious bias regardless of an evaluator’s political philosophy. EDEI should publish the practicum scoring rubric, identify objective passing and failure criteria, disclose whether inter-rater reliability has been tested, explain mandatory conflict and recusal procedures, and identify the appellate process available to a clinician who believes political, ideological, professional or personal disagreement affected an evaluation. Most importantly, EDEI should disclose whether any appeal ultimately reaches a person or body genuinely independent of EDEI leadership.

15. Will EDEI submit the finished EDCS program to genuinely independent review and disclose the results?

This question ultimately encompasses almost all the others. Will EDEI provide qualified independent reviewers with its ownership and related-party information, complete Delphi methodology, competency framework, examination blueprint, psychometric analyses, passing standards, practicum rubric, evaluator training procedures, conflicts policies, appeals system and records showing how pre-launch credential holders obtained EDCS? If EDEI believes EDCS represents a legitimate professional standard, independent scrutiny should strengthen the credential rather than threaten it.

These Questions Should Be Easy to Answer

Eating disorder education desperately needs improvement, and an organization capable of providing rigorous education could make an important contribution to the field. That need, however, does not establish the validity of a privately created professional credential, nor does it excuse the organization issuing that credential from ordinary expectations of transparency, independent validation and freedom from conflicts.

The questions above do not require disclosure of trade secrets or confidential patient information. They ask what EDCS means, who independently validated it, how insiders obtained it, who owns and financed the enterprise, what relationships exist with affiliated treatment businesses, what authority its President exercises, whether applicants may disagree with her political philosophy, and what safeguards protect credentialing decisions from bias. Those are precisely the subjects a professional organization should expect clinicians to examine before paying thousands of dollars for a designation and placing it beside their professional licenses and degrees.

EDEI and its leadership are invited to answer all fifteen questions publicly, and any substantive answers should be made available so clinicians, patients and families can evaluate the responses for themselves. If a particular question rests upon an incorrect premise, EDEI should identify the error and produce the facts correcting it. Transparency does not require agreement with critics; it requires a willingness to answer legitimate questions with verifiable information.

If EDEI again chooses not to respond, that silence should not necessarily be characterized as proof that every criticism of the organization is correct. It does, however, become relevant evidence concerning institutional transparency. A credentialing organization that expects clinicians to submit their education, judgment and professional competence to EDEI’s scrutiny should reasonably be expected to submit EDEI’s own standards, governance and conflicts to scrutiny in return.

The eating disorder community does not have to decide today whether EDCS is a good credential or a bad one. It first needs enough information to determine what EDCS actually is, what evidence supports it and whether the organization issuing it deserves the authority it is attempting to exercise. These fifteen questions provide EDEI with an uncomplicated opportunity to supply that information, and if its leadership continues to decline that opportunity, clinicians should take that refusal into account before entrusting EDEI with their money, professional reputation or confidence.

Eating disorders have traditionally been grouped according to what patients do. A person restricts food. Another binges. Someone purges. Still others exercise compulsively. A patient becomes dangerously underweight. Another lives in a larger body while experiencing episodes of uncontrollable eating. Clinicians understandably focus on these behaviors because they are the immediate manifestations of the illness and, in some cases, can become life-threatening. Now, genetics is beginning to help us understand some of the biology that may help explain why those patterns develop.

A major international genetic study published on August 19, 2026, in Nature Mental Health analyzed genetic data involving more than 24,000 people with anorexia nervosa and more than 39,000 people identified as having binge-eating behavior across several datasets, together with more than one million comparison participants in each analysis. Researchers from around the world participated, including investigators from the University of Otago in Christchurch, New Zealand.

That study can be found here:

https://www.nature.com/articles/s44220-026-00698-2.pdf?utm_source=chatgpt.com

The findings do not give us a genetic test for an eating disorder, identify an “anorexia gene” or “binge-eating gene,” or establish that environment, trauma, dieting, culture or psychological experiences are unimportant.

What the findings do reveal may be more consequential. The study strengthens the evidence that anorexia and binge-eating behavior involve numerous genetic influences and that these seemingly different presentations can share important underlying vulnerabilities while diverging substantially in other areas of biology. Perhaps most importantly, the findings provide additional evidence that eating disorder biology cannot simply be reduced to the biology of being thin, being heavier or having a particular body mass index. That distinction could eventually change how eating disorders are understood, classified and treated.

What Does a Genetic Study Like This Actually Tell Us?

The study is what scientists call a genome-wide association study, or GWAS. The concept is easier to understand than the terminology. Human beings share almost all their DNA, but millions of small genetic differences exist among us. Researchers can compare very large groups of people with and without a particular illness or behavior and ask whether certain genetic variations appear more frequently in one group than another. With sufficiently large numbers, patterns begin to emerge.

Researchers generally are not finding one gene that causes an eating disorder. Eating disorders appear to be polygenic, meaning many genetic variations, each usually contributing only a very small amount of risk, interact with one another and with a person’s biology, development and environment. A useful way to think about genetic vulnerability is as hundreds or thousands of tiny weights placed on a scale. No single weight determines the outcome, but together they can influence susceptibility. That is why someone can carry substantial genetic risk and never develop an eating disorder, while another person with genetic vulnerability may develop one when that vulnerability interacts with other biological, psychological or environmental factors. Genes are not destiny, but neither are they irrelevant background information.

Anorexia and Binge Eating Share Something Important

One of the study’s most interesting findings is that anorexia nervosa and binge-eating behavior share a meaningful amount of genetic vulnerability. At first, that may seem surprising. Anorexia and binge eating can appear almost opposite. One may involve severe restriction, while the other involves episodes of eating accompanied by loss of control. Anorexia is often associated with very low weight, while binge eating occurs across the weight spectrum and is frequently associated with higher weight. Yet their genetics suggest that they are not completely unrelated.

The researchers found a moderate genetic relationship between anorexia and binge eating, while additional modeling suggested substantial overlap among genetic variants contributing to susceptibility to the two phenotypes. At the same time, important differences emerged. Binge eating showed stronger genetic relationships with ADHD, smoking, problematic alcohol use and general risk tolerance. Anorexia showed a different pattern, including a stronger genetic relationship with obsessive-compulsive disorder and the unusual combination seen in previous research of psychiatric, metabolic and body-composition associations.

These findings must be interpreted carefully. They do not mean that binge eating is simply a problem of impulse control or that everyone who binges has ADHD, abuses alcohol or engages in risky behavior. Nor do they mean that everyone with anorexia has OCD. These are population-level genetic relationships suggesting that some biological systems involved in these other traits may overlap with systems affecting susceptibility to eating disorder behaviors.

The findings may also help explain something clinicians routinely observe. Eating disorders do not always remain neatly within diagnostic boundaries. A person may severely restrict at one stage of illness and later develop binge or purge symptoms. Another may move between diagnoses over time. Binge eating itself can occur in binge-eating disorder, bulimia nervosa and some presentations of anorexia nervosa. At least some of that clinical overlap may eventually prove to reflect shared biology rather than simply changing behavior.

Eating Disorders Are Not Simply Disorders of Body Weight

One of the study’s most important analyses involved BMI. Because anorexia is frequently associated with very low body weight and binge eating is often associated with higher weight, the researchers asked whether their genetic findings were essentially detecting genes related to body size rather than genes related to the eating-disorder phenotypes themselves. The answer was largely no.

For binge-eating behavior, the genetic component shared with BMI accounted for about 12 percent of the genetic variation being modeled, while approximately 88 percent remained in a component not shared with BMI. For anorexia nervosa, the BMI-shared component accounted for approximately 10 percent, while about 90 percent remained in the non-BMI component.

Those numbers require careful explanation. They do not mean that 90 percent of anorexia is genetic, that weight is unimportant in anorexia, or that 90 percent of the causes of anorexia have nothing to do with body weight. They mean something much more specific: when researchers examined the genetic signals associated with anorexia, most could not simply be explained by genetics associated with having a lower BMI. The same principle applied to binge eating and higher BMI.

The researchers concluded that their findings were not simply “BMI studies by proxy.” That is a significant distinction because weight can be a critically important manifestation of an eating disorder without being an adequate explanation for the disease itself.

Being Naturally Thin Is Not the Same Thing as Having Anorexia

Another finding reinforces that point. Researchers compared anorexia with persistent thinness, meaning people who remain naturally very thin but do not have anorexia nervosa, and found no significant genetic overlap between persistent thinness and anorexia.

Clinically, this may seem obvious, but biologically it matters. Imagine two people with similarly low body weights. One eats normally, does not fear weight gain, does not compulsively restrict and has always been naturally thin. The other has anorexia nervosa and experiences restriction, fear, rigidity, compulsive behaviors or other features of the illness. Their bodies may look similar, but that does not mean the underlying biology is the same.

The finding also reinforces why clinicians should be cautious about defining restrictive eating disorders by weight alone. A person with atypical anorexia nervosa can experience severe restriction, psychological symptoms and significant medical compromise without ever reaching a conventionally underweight BMI. The disease is not simply the number on the scale.

Anorexia Is Looking Increasingly Like an Illness of Both the Brain and the Body

This study builds upon an important finding from major anorexia genetics research published in 2019. That earlier work found genetic relationships not only between anorexia and psychiatric conditions, but also with metabolic characteristics, physical activity and body composition. The researchers proposed reconsidering anorexia as a “metabo-psychiatric” disorder, meaning an illness involving both psychiatric and metabolic biology.

The new study strengthens that broader concept. Our traditional understanding of anorexia can become too linear: a person develops psychological problems, those problems cause restriction, restriction causes starvation and starvation then causes metabolic abnormalities. Some of that unquestionably occurs because starvation profoundly affects virtually every organ system, including the brain.

However, genetics raises another possibility. Some metabolic characteristics may contribute to a person’s vulnerability to anorexia rather than existing only as consequences of starvation. That does not mean metabolism causes anorexia. It means that brain function, behavior, appetite, energy regulation, activity and metabolism may be considerably more intertwined than our traditional categories have suggested. If that proves correct, the implications for treatment could eventually be substantial.

Why Can Recovery Be So Difficult?

Families often encounter one of the most painful mysteries of eating disorders. A person may understand intellectually that the illness is dangerous, know that they need nutrition and desperately want their life back, yet remain unable to eat adequately, tolerate weight restoration, stop exercising or resist the behaviors of the illness. From outside the disease, this can be extraordinarily difficult to understand.

Genetic research does not yet tell us exactly why this happens, but it gives us another reason to reject simplistic explanations based on stubbornness, vanity, defiance or lack of motivation. If eating disorder vulnerability involves biological systems affecting anxiety, compulsivity, reward, appetite, activity, metabolism or behavioral control, then a patient may be experiencing pressures that neither the patient nor the clinician can currently measure. A person can rationally understand something and still have powerful biological systems pushing in another direction.

The emerging genetics do not yet explain treatment resistance or recovery at the individual level. What they provide is a biological framework within which researchers may eventually understand these clinical experiences much better.

The Future May Be Less About “Which Eating Disorder?” and More About “Which Version?”

This may be the most important long-term implication of the research. Today, diagnosis is based primarily on symptoms. Two patients who meet diagnostic criteria for anorexia nervosa receive the same diagnosis, yet those two people may be remarkably different. One may have pronounced anxiety and obsessive-compulsive characteristics. Another may have an unusually strong drive for physical activity. Another may have prominent metabolic features, while another repeatedly moves between restriction and binge or purge behaviors.

What if some of those differences reflect more than personality or presentation? What if they represent different biological pathways leading to what we currently call the same disorder? This study does not identify such biological subtypes today, but it points toward a research direction in which they may eventually become identifiable. The researchers themselves raise the possibility that genetics could someday contribute to a more biologically informed classification of eating disorders.

Medicine has undergone similar transformations elsewhere. Cancer provides an imperfect but useful comparison. Modern oncology increasingly examines molecular differences among tumors because two people with cancer in the same organ may have diseases that respond very differently to treatment. Eating disorders are nowhere near that level of precision, but the same conceptual possibility is important.

Imagine a future in which two patients with anorexia are no longer automatically assumed to have biologically identical illnesses simply because they satisfy the same diagnostic checklist. Treatment might eventually consider which biological systems appear most involved in each person’s disease. That is the promise of precision medicine.

Such a change could affect psychotherapy, medication development and clinical trials. A patient whose illness is strongly associated with rigidity and compulsivity may eventually benefit from a different therapeutic emphasis than someone whose dominant vulnerability involves reward processing or emotional regulation. Researchers testing medications may also become better able to identify subgroups who respond to treatments that appear ineffective when everyone with the same diagnosis is analyzed together. These are possibilities, not findings established by this study, but they are reasonable directions suggested by a growing body of biological research.

Could Genetics Lead to New Medications?

Potentially, although not immediately. The study identified several regions of DNA associated with anorexia and binge-eating behavior. For binge eating, one of the strongest associations involved the region around FTO, a gene long connected with body weight. The researchers raised the possibility that part of FTO’s relationship with higher BMI could involve eating behavior itself.

For anorexia, researchers confirmed several previously identified regions and identified additional ones. They also found evidence involving genes participating in neuronal RNA processing and alternative splicing. These are starting points, not treatments. Finding a genetic region associated with an illness does not mean scientists have discovered “the gene” responsible for it. Researchers still must determine what biological process is being affected, how that process influences illness and whether it can be safely altered.

The genetic analysis also pointed toward biological targets associated with a class of anti-migraine medications, consistent with previous genetic relationships between migraine and anorexia. But no one should read this study and conclude that migraine medication has been established as a treatment for anorexia. It has not.

The importance of such findings is that genetics may provide leads. Over time, those leads could help researchers identify biological pathways that might be targeted with new or repurposed medications. That possibility is especially important in anorexia, where medication development has lagged far behind many other serious psychiatric illnesses.

Could We Eventually Identify People at Risk Earlier?

Again possibly, but we are not there yet. Researchers can combine thousands of genetic differences into what is called a polygenic risk score. The goal is to estimate inherited susceptibility by looking at many small genetic signals rather than searching for a single causative gene.

The scores used in this study could statistically distinguish some people at greater risk, but their predictive power remains far too weak for routine clinical use. There is currently no useful genetic screening test for anorexia or binge eating. Parents should not buy commercial genetic tests expecting them to determine whether their child will develop an eating disorder, and clinicians should not make treatment decisions based on such testing.

The future could be different. Risk assessment might someday combine family history, genetic susceptibility, early eating behaviors, anxiety or compulsivity, metabolic characteristics, changes in growth, activity patterns, developmental factors and other warning signs. No single factor would have to predict an eating disorder. Together, they might eventually help clinicians identify some vulnerable people earlier, before the illness becomes deeply entrenched.

The Research is Important for Families

One consequence of biological research has nothing to do with technology. It concerns blame. Families were once directly blamed for causing eating disorders, particularly anorexia. Modern treatment has moved a considerable distance from those theories, but parents and loved ones can still carry enormous guilt.

Genetic research provides another reason to reject the idea that a parent simply caused a child’s anorexia by saying the wrong thing, serving the wrong food or creating the wrong family environment. At the same time, genetics should not create a different form of fatalism. A genetic vulnerability does not mean recovery is impossible.

Genes influence risk. They do not write an unavoidable script. A family history of heart disease does not guarantee that someone will die of heart disease, and genetic vulnerability to depression does not make depression untreatable. The same principle applies here. Biology can create vulnerability while nutrition, medical care, psychotherapy, family support, relationships and environment can still profoundly affect what happens. For families, perhaps the most important message is to take the illness seriously without treating it as the patient’s fault or anyone else’s.

What This Study Does Not Prove

The excitement surrounding this research requires boundaries. The study does not prove that eating disorders are “genetic diseases” in the simple sense that Huntington’s disease or cystic fibrosis are genetic diseases. Eating disorders involve many genes interacting with development and environment. Nor does it establish that sociocultural influences are irrelevant. A genetically vulnerable brain still develops in a social environment, and dieting, trauma, bullying, weight stigma, cultural expectations and other experiences can matter.

The study also does not establish that current treatments are misguided. Nutritional rehabilitation, psychotherapy, medical monitoring and family support remain central components of care. Nor does the research provide a clinically useful genetic test or a newly proven medication.

There are important limitations in who was studied. The principal genetic analyses involved people of European ancestry because sufficiently large datasets from other populations were not available, which limits how confidently the findings can be generalized to other populations. The samples were also overwhelmingly female, with approximately 96 percent of the binge-eating group and 94 percent of the anorexia group being female. The researchers found some indication that genetic risk identified in females also applies to males, but there were too few male participants to determine whether male eating disorders have distinctive genetic characteristics. That limitation matters in a field that has historically underdiagnosed and understudied boys and men.

Finally, the binge-eating analysis was broader than a study of formally diagnosed binge-eating disorder. Participants were identified through several datasets and definitions of binge-eating behavior. The findings therefore should not be described as though they apply exclusively to people with a formal diagnosis of binge-eating disorder.

What Changes Today?

Clinicians should not change treatment protocols because of this study alone. There is no new genetic test to order, no newly established medication to prescribe and no genetic result that tells a family which therapy will work. What should continue to change is our understanding of the illness.

The scientific evidence increasingly argues against viewing an eating disorder primarily as a problem of food, weight, body image or social influence with biology added as an afterthought. The emerging model is considerably broader. Eating disorders appear to involve complicated interactions among inherited vulnerability, brain function, psychiatric characteristics, metabolism, development and environment.

The visible behaviors remain critically important. Restriction must be interrupted. Malnutrition must be treated. Purging must be addressed. Binge eating must be understood and treated. Medical instability requires medical care. But those behaviors may be surface manifestations of biological systems that differ substantially among patients.

That possibility should change the questions we ask. Instead of only asking why a patient will not eat, we may eventually understand which biological systems make eating so threatening or difficult. Instead of asking why someone cannot stop binge eating, we may better understand how appetite, reward and behavioral control systems are interacting. Instead of wondering why treatment worked for one person and failed another, we may discover that the two patients never had biologically identical illnesses in the first place.

The old argument over whether eating disorders are psychological or biological may itself become increasingly obsolete. The brain is biological. Psychological experience can change biology. Genes influence behavior. Environment influences biology. Starvation changes the brain. Metabolism communicates with the brain. These systems interact.

A Different Way of Seeing the Patient

Perhaps the most immediate value of this research is not a medication, a genetic test or a new diagnostic category. It is perspective. Eating disorders can produce behaviors that bewilder experienced clinicians and terrify families. A patient may resist the very nutrition needed to keep them alive. Someone may repeatedly engage in behavior they desperately want to stop. Intelligence, love, logic and fear of consequences can all seem insufficient to overcome the illness.

Genetics does not explain every one of those experiences, but the expanding evidence increasingly tells us that we are looking at disease, not simply difficult behavior. The Nature Mental Health study is not the final answer to what causes anorexia or binge eating. It may eventually be remembered as one step in a much larger scientific transition, away from defining eating disorders almost entirely by what patients do and toward understanding the biological processes that make those behaviors so difficult to change.

That transition may ultimately matter far more than discovering any single gene. The real promise of genetics is not that medicine will someday tell a patient, “We found your eating disorder gene.” The more meaningful possibility is that medicine may someday be able to say something far more useful: we understand much more about the particular form of this illness affecting you, and because we understand it better, we know much more precisely how to treat it.

Inclusion and Gender Equality Means Cisgender Boys and Men are not Allowed.

The Renfrew Center presents itself as an “inclusive” eating disorder treatment system. Its website says eating disorders affect people regardless of gender, describes diversity as something to be celebrated, advertises specialized programming for historically marginalized populations, and tells prospective patients that cost should not prevent access to care.

However, its admissions policy contradicts that message. “Inclusion” ends at the admission door.

Renfrew offers treatment to “cisgender adolescent girls and women,” “transgender adolescents and adults,” and “gender non-binary adolescents and adults.” The missing element? Cisgender boys and men. A biological male who identifies as a woman can qualify for admission, as can a transgender man or nonbinary patient, while a biological male who identifies as a man cannot.

This is not an ambiguity buried in an outdated brochure. Renfrew has defined the categories itself and continues to publish them under the heading “Expert Care for All.” What Renfrew failed to do is to say that its “Expert Care for All” specifically excludes boys and men. Unless of course you are transgender or non-binary. The hypocrisy is appalling.

The Excluded Population Is Substantial

This exclusion cannot be defended as affecting some negligible fraction of the eating disorder population. The American Psychological Association reports that boys and men account for approximately one third of people diagnosed with eating disorders and describes the long history of male patients being overlooked because these illnesses were treated culturally and clinically as diseases of girls and women. Male patients were underrepresented in research, screening instruments frequently reflected female presentations, and diagnostic criteria historically incorporated assumptions tied to female biology.

Renfrew emerged from that history. When it opened in 1985, the organization was built around the treatment of women and girls, a model consistent with the prevailing view of eating disorders at the time. Scientific understanding changed, and Renfrew expanded its admission categories, but it did so without correcting the exclusion of cisgender males.

The resulting policy is more difficult to justify than Renfrew’s original women only model. Renfrew no longer limits treatment to women, nor does it limit admission according to biological sex. Instead, it admits patients across several gender identities while continuing to reject males who identify as male.

That distinction affects a population already harmed by the eating disorder field’s historic failure to recognize them. A boy with anorexia does not have a less serious disease because he identifies as male, and an adult man with bulimia or binge eating disorder does not require less specialized treatment because his biological sex and gender identity correspond. Yet under Renfrew’s published policy, that characteristic excludes him.

If Renfrew contends that its therapeutic model requires a female environment, the admission of transgender women and nonbinary patients defeats that explanation. If biological sex supplies the justification, the admission of transgender women who were born male creates the opposite problem. If gender identity controls, Renfrew is left attempting to defend a policy under which identifying as male becomes the characteristic that closes the door.

Those operational concerns cannot explain the categorical exclusion of cisgender boys and men. Renfrew has already demonstrated that its historical treatment model can be modified to accommodate patients who fall outside the population for which the institution was originally designed. It has chosen not to make that accommodation available to cisgender males.

Financial Inclusion Has Its Own Boundary

Renfrew’s claims about accessibility extend beyond gender. Its website says the cost of care “should never get in the way of quality treatment,” advertises acceptance of more than 400 insurance plans, and prominently identifies Aetna, Blue Cross Blue Shield, Cigna, Optum/United Behavioral Health and Fidelis Care.

Medicare and Medicaid are not specifically identified on that page. Renfrew knows how to tell commercially insured patients that major carriers are accepted, yet patients who depend on the country’s principal public insurance programs receive no comparable statement about access.

The omission is particularly significant because Renfrew may participate in Medicaid managed care in New York. Renfrew publicly states that it is in network with Fidelis Care for all levels of in person and virtual care. The question remains, does the Fidelis relationship include Fidelis Medicaid Managed Care?

That fact changes the character of the inquiry. Medicaid reimbursement is not merely another commercial payment source. It includes federal financial assistance and carries federal civil rights obligations. A provider accepting that funding cannot separate its public claims of “inclusion” from the nondiscrimination requirements attached to participation in federally funded health care.

Federal Money Carries Federal Civil Rights Obligations

If Renfrew accepts Fidelis Medicaid Managed Care, it is subject to Section 1557 of the Affordable Care Act, 42 U.S.C. § 18116(a), which prohibits discrimination on grounds incorporated from federal civil rights statutes, including sex discrimination under Title IX, in covered health programs receiving federal financial assistance.

The current regulations reinforce that prohibition. Under 45 C.F.R. § 92.101(a)(1), an individual may not, on the basis of sex, be excluded from participation in, denied the benefits of, or subjected to discrimination under a covered health program or activity. Section 92.4 defines covered health programs broadly and provides that, for an entity principally engaged in providing health care, the relevant program can encompass all of the entity’s operations.

Renfrew’s published policy presents a direct sex discrimination question. A cisgender woman with an eating disorder falls within the population Renfrew says it treats. Transgender and non-binary people are welcomed. But a cisgender man with the same diagnosis falls outside it. The distinction is categorical and precedes any individualized clinical judgment.

The legal claim of a cisgender boy or man does not depend on contested federal protections for transgender status. His complaint is far simpler: he is male, he has an eating disorder Renfrew treats, and on the basis of sex, Renfrew excludes him from eligibility while admitting female patients.

Taken together, those facts present a focused federal question. Sources have said that Renfrew’s New York operation participates in Medicaid managed care, its provider NPI identifies The Renfrew Centers, Inc. as the legal business name, and the organization publishes a categorical admissions policy excluding cisgender boys and men.

If discrimination on the basis of sex is established, and if Renfrew accepts federal funds through Fidelis Medicaid Managed Care, they are subject to federal law. And now they may have a huge issue.

In the event Renfrew does not accept Medicaid funds, it can carte blanche continue with its discriminatory conduct with impunity from the federal government. Renfrew would then merely be hypocritical and beneath contempt. But, it’s conduct would not technically be illegal. But, if it is accepting Medicaid funds …

Meanwhile, additional issues continue internally.

Residential Treatment Forces the Issue Into the Room

Renfrew’s expansion beyond cisgender women also creates practical issues that do not arise in the abstract language of “inclusion.”

Renfrew operates residential treatment facilities in Philadelphia and Coconut Creek, Florida. At its Philadelphia residential campus, Renfrew tells incoming patients that most bedrooms contain two beds and that patients will likely have a roommate. Its published explanation says roommates are “typically paired by age,” separating adolescents from adults. It does not publicly describe gender identity, biological sex, anatomy, trauma history or patient preference as roommate matching criteria. Admitting transgender and nonbinary patients necessarily requires policies governing privacy, trauma histories, roommate assignments and intimate residential settings. Whatever difficulties accompany those decisions, Renfrew has decided they can be managed when the patient is transgender or nonbinary.

If a cisgender adolescent girl may share a bedroom with a transgender adolescent, parents are entitled to know the criteria governing that placement. The same is true for a transgender patient whose trauma history or privacy concerns may make another placement inappropriate. The clinically serious answer cannot be that identity automatically overrides every other consideration.

Those issues demand transparency.

Renfrew’s own educational material says eating disorders do not discriminate. Its “inclusion” campaign recognizes that men have historically been overlooked. Its support programming is organized around populations that have experienced marginalization (except boys and men). Its financial materials say cost should not stand between a patient and quality care. Mere empty words contradicted by its own conduct.

On September 2, 2026, Renfrew is rolling out a new virtual support group, “Sexuality and Gender Equality (SAGE) Support Group.” Gender equality? Renfrew’s hypocrisy cannot be understated. Pontificating on “gender equality” while systemically excluding a population which may consist of up to 1/3 of those afflicted with eating disorders is the height of inane hubris. It would almost  be humorous … if it was not so tone deaf and tragic.

After four decades of very little progress in our understanding of eating disorders, the most excluded patient is not difficult to identify.

He is the boy with anorexia.

He is the male college athlete purging in secrecy.

He is the gay man whose sexuality may place him at elevated eating disorder risk.

He is the middle-aged father with binge eating disorder.

He is the patient the eating disorder field spent years failing to see.

And at Renfrew, he is the patient standing outside … unwanted and ignored.

The Eating Disorders Education Institute (“EDEI”) wants clinicians, employers, treatment programs, and patients to treat its soon to be released credential program, EDCS, as evidence of specialized competence in eating disorder care. But a credential is only as credible as the institution issuing it. Before EDEI asks the field to trust EDCS, it must first establish why EDEI itself deserves the trust of the community.

So the question must be asked … what has EDEI done to deserve anyone’s trust? At this point, the answer is … remarkably little.

A Credential Built by Its Own Beneficiaries

EDEI is owned by a for profit limited liability company. Its leadership developed the curriculum. Founder and CEO Dr. Wendy Oliver-Pyatt already places the designation after her own name. However, the EDEI has released no evidence that the finished credential predicts clinical competence, improves patient outcomes, reliably distinguishes qualified clinicians from unqualified clinicians, or has been independently validated by an established independent specialty body, university, licensing authority, or accrediting organization.

Although EDEI may assert this as credentialing, the facts and evidence speak otherwise. Dr. Oliver-Pyatt’s for-profit organization created the standard, built the curriculum, evaluates candidates against its own requirements, awards the designation, and benefits financially if EDCS acquires value. However, authority does not become legitimate through self-declaration and profiteering.

To exacerbate this issue, the people asking the field to accept their authority make the credibility problem considerably worse.

Independence by Assertion

Chevese Turner, who is marketed as EDEI’s Founding Partner and President, recently attempted to respond to questions about the organization’s independence by declaring: “EDEI is not owned by a corporation, has no outside investors and no VC funding. Did it all ourselves out of pocket too.”

The statement sounds sweeping. It is not.

As previously stated, EDEI is owned by and operates through the Institute for Contemporary Eating Disorder Education, LLC., a for profit organization. Dr. Oliver-Pyatt founded that organization and serves as its CEO while simultaneously serving as co-founder, CEO, and Chief Medical Officer of Within Health. Ms. Turner serves as a Within Health advisor. EDEI uses a current Within Health senior clinical leader as an instructor.

The intertwined corporate and organizational structure extends much further.

A California Secretary of State filing dated April 30, 2024, identifies Within Health Group, Inc. as a manager or member of Hopeful Media, LLC. [Members are owners of an LLC. Managers in general, control the daily operations.] Hopeful Media owned and operated EDHope, a website positioned before vulnerable consumers at the precise stage when they are researching illnesses, comparing levels of care, evaluating treatment providers, and deciding whom to call.

Abhilash Patel sits in the same structure. He co-founded Within Health with Dr. Oliver-Pyatt and remains its president. Within Health describes Patel as a venture capital investor, while his professional history includes acquisitions, digital publishing, search marketing, behavioral health customer acquisition, telephone lead generation, and company growth. Patel’s investment firm, Thermal, works with early-stage companies, investment firms, and private investors.

Private capital also appears elsewhere in Dr. Oliver-Pyatt’s business network. Lindsay Goldberg identifies Sero Mental Health as an investment beginning in 2021, and corporate records connect Galen entities to that structure. Dr. Oliver-Pyatt is the founder and CEO of Galen Hope, one of the entities in the Galen system.

Against this record, Ms. Turner’s statement that EDEI itself has “no VC funding” answers very little. Direct equity ownership is only one way in which commercial enterprises can share money, personnel, technology, intellectual property, marketing infrastructure, administrative support, professional relationships, or strategic assistance.

But Ms. Turner went further. She said the founders did it entirely “out of pocket.” That is an alleged factual representation. EDEI must be able to substantiate it.

Identify the owners. Produce the operating agreement. Disclose the capital contributions and loans. Identify any related company that supplied employees, contractors, software, marketing, administrative services, intellectual property, office resources, or other support. The records can establish whether Within, Patel, Thermal, Galen, Sero, Hopeful Media, or another connected enterprise contributed anything of value.

Ms. Turner is attempting to peddle separation. The documented structure shows integration.

What Happens When the Network Receives Scrutiny

The history of Within Health and EDHope provides another reason not to accept assurances of independence at face value.

Ms. Turner previously appeared on Within Health’s advisor roster. So did Jacquelyn Ekern, founder and former owner of EDHope. On February 16, 2026, I published an article examining Within Health’s leadership and advisor composition. At that time, Within Health publicly identified a nine-person Board of Advisors, eight women and one man. The article focused in part on the records of people serving on that board. Within days, the advisor roster disappeared from the website, taking Ms. Turner’s and Ms. Ekern publicly displayed advisory relationship with it.

Ms. Ekern’s presence on that board became more consequential as the corporate relationships came into focus. Within Health Group already held a formal governance or ownership position of Hopeful Media in April 2024. Hopeful Media now operates EDHope as a Within Health company. Ms. Ekern, the founder of EDHope occupied an advisory position at the treatment company connected to the corporate structure that came to control EDHope. The public presentation of that relationship produced another revealing sequence.

On July 27, I examined EDHope’s claim that it remained an independent resource after becoming part of the Within Health structure. At the time, the website prominently invited treatment seekers to call a telephone number that routed directly to Within Health. The ownership relationship was not stated beside the number. EDHope instead used softer language such as “powered by Within,” while continuing to describe itself as independent and unbiased.

The article focused directly on that arrangement, including the treatment call routing, the ownership disclosures, the financial conflict created when a treatment company controls a provider discovery platform, and the difference between an independent resource and an admissions pathway leading to the company that owns it. EDHope’s homepage looked like this:

Shortly afterward, the presentation changed.

EDHope’s homepage now identifies the number, a different telephone number, as “Within Health Admissions.” The site states that calls currently direct to Within Health and now tells visitors near the top of the page that Eating Disorder Hope is “Owned and maintained by Hopeful Media, a Within company.”

Why were those changes implemented? If the website and relationship were transparent, why the changes? EDHope continues to call itself an “independent resource” and says it connects users with providers “without bias toward any specific program or organization.” The same homepage then directs treatment callers to Within Health Admissions, while its footer identifies Hopeful Media as a wholly owned subsidiary of Within Health Group, Inc.

The sequence speaks for itself.

Public scrutiny of Within Health’s advisors was followed by disappearance of the advisor roster. Public scrutiny of EDHope’s treatment number and ownership presentation was followed by substantially clearer disclosures that the new number listed leads to Within Health Admissions.

Transparency became more explicit only after someone started asking questions. Now the same people want clinicians to trust another assertion of independence and credibility.

The Credentialing Network

The issue is larger than whether EDEI and Within Health occupy different boxes on an organizational chart.

Dr. Oliver-Pyatt stands at the center of both enterprises. Ms. Turner moved from Within Health’s advisory structure into leadership of EDEI. A Within Health clinical leader teaches through EDEI. Within Health’s corporate network reaches Hopeful Media and EDHope, placing treatment, professional education, digital publishing, treatment discovery, advertising, and patient acquisition within overlapping business and professional relationships.

That is a commercial marketplace for access to people actively searching for treatment. EDEI wants the eating disorder community to treat these operations as sufficiently separate whenever independence becomes important. The record does not support that presumption.

Credibility Is the Larger Problem

Even complete financial separation would not answer the more serious question surrounding EDCS.

Why should Dr. Oliver-Pyatt and Ms. Turner decide who qualifies as an eating disorder specialist?

EDEI did not receive that authority from any medical specialty board, state licensing agency, university, or established independent professional body. It created EDCS itself. Dr. Oliver-Pyatt already uses the designation. [which by itself, may present a serious ethical issue with the Florida Medical Board.] EDEI/Within Health’s leadership developed the curriculum, invokes its own Delphi process as support, teaches the material, evaluates candidates, and awards the credential.

A private, for-profit organization is attempting to manufacture professional authority and then persuade an established field to recognize the product. The people controlling that process therefore deserve scrutiny at least as rigorous as the scrutiny they intend to impose on clinicians.

Ms. Turner’s public record raises serious questions about whether EDEI can credibly promise neutral evaluation.

Before entrusting Ms. Turner with authority over a credential that purports to identify clinical expertise, we should consider her past conduct and statements while exercising leadership in this field. As NEDA’s Chief Policy and Strategy Officer, Ms. Turner stated that people who had confronted their internal biases “no longer trust the medical establishment to actually help us.” [Does she now trust the medical establishment behind EDEI?]

In a podcast, Ms. Turner stated, “There may be some things with eating disorders that are brain issues. I don’t know.” Despite not knowing about an incredibly important biological/medical aspects of eating disorders, her attacks on the medical community continued.

“We have fought back in the Body Positivity Movement and don’t want to be judged on our looks, and our body size and the medical community has said ok, we will judge you on your health.” Isn’t that what the medical community does? Address health issues? Finally, Ms. Turner stated, “My heart is in the higher weight community, whether a person has an eating disorder or not.”

Ms. Turner also embraces a political framework centered on weight, oppression and identity and supports proposals extending far beyond conventional eating disorder treatment. Her public statements included demands to center selected identity groups while telling “white, straight and thin folks” not to enter certain discussions. On another podcast, Ms. Turner stated, “Our culture is set up to value and promote Whiteness.” She also stated, “It bothered me that all the air was taken by a white perspective.” Ms. Turner continued, “Let’s also acknowledge that professionalism and tone policing/politeness are constructs of systems that are embedded by white supremacy ideals. When we constantly protect the feelings of those who are oppressing then we never actually get to the work needed to undo the oppression.”

She has now made the relationship between politics and EDEI’s educational philosophy explicit, describing the work as “very political” and saying there is “no room for neutrality.” Ms. Turner goes further still when she stated, “I believe bodies are political. Everything is political.”

Those statements cannot be brushed aside when EDEI uses live practicums in which its own evaluators judge clinicians’ reasoning and readiness.

A physician may reject weight neutrality as a governing medical doctrine. A psychologist may decline to use intersectionality as a clinical framework. Dietitians can disagree with body liberation theory. Other clinicians may believe political advocacy should remain separate from determinations of medical and professional competence. EDEI has not explained what happens when those clinicians sit across from evaluators working within an organization whose president says neutrality has no place in the work.

Ms. Turner’s history gives the question additional weight. She has publicly accused perceived opponents of “gaslighting,” described men she opposed as “upskirting” the eating disorder community, criticized women who associated with those individuals, and invited others to join her in “being difficult when it comes to these people.”

Those statements reveal how Ms. Turner has treated people she regarded as adversaries or with whom she disagreed while exercising influence in this field.

Ms. Turner’s account of the competing IEDS credential creates a separate credibility problem. She stated categorically that EDEI had been developing EDCS for more than three years and that “we were not aware that the IEDS folks were working on their credential.” The contemporaneous record says otherwise.

On numerous occasions and as early as 2024, IEDS had been discussed and self-promoted as a certification program in an Eating Disorders Professional Group on Facebook. Ms. Turner actively participates in that group and has promoted the EDCS in that group. It is implausible that Ms. Turner did not see those posts. When directly confronted with that history her answer was … silence.

That matters because EDEI is selling judgment.

Its leaders want clinicians to trust their representations about independence, validation, professional standards, competing credentials, and the process by which candidates will be evaluated. Credibility therefore cannot be separated from accuracy when those same leaders speak publicly about matters within their field.

EDEI now proposes to place evaluative authority in the hands of Ms. Turner.

A Failed Attempt to Capture Professional Authority

EDEI is not simply offering another continuing education course. EDEI is attempting to position itself as the authority which defines the standard, teach the standard, evaluate compliance with the standard, and decide who may publicly claim the resulting distinction. That is an attempt to capture professional authority within an eating disorder community that never granted EDEI that authority.

The burden to establish credibility and authority belongs where EDEI has tried to avoid placing it. On EDEI. When organizations or persons shy away from and refuse to answer direct questions, there are very few reasons supporting the justification for silence.

Produce the validation. Disclose the finances. Identify the institutional support. Explain the scoring. Establish the independence of the evaluators. Account for the overlapping commercial relationships. Reconcile Ms. Turner’s public statements with the documentary record. Explain why political conformity cannot influence a live practicum controlled by an organization whose president says there is “no room for neutrality.”

Finally, be transparent. Either admit that EDEI agrees with and has adopted Ms. Turner’s radical political and social justice positions and those now constitute fundamental aspects of EDCS. Or publicly and strongly refute them. After all, in Ms. Turner’s words, “there is no room for neutrality.”

Until answers are provided, until EDEI embraces transparency, EDCS is not evidence that EDEI possesses authority over the eating disorder profession. Instead, it only constitutes evidence that EDEI is attempting to hijack that authority.

Today, August 10, 2026, my daughter Morgan would have turned 33 years old

In the past ten years, I learned that birthdays do not disappear when a loved one dies. They change. The celebrations we once imagined become quieter, more complicated occasions. Joy and grief occupy the same space. Memories arrive without warning, carrying laughter one moment and an almost physical sense of absence the next.

Still, Morgan’s birthday deserves to be celebrated.

She was born in Dallas on August 10, 1993. From the beginning, she brought intensity, humor and energy into our family. Morgan was intelligent and quick witted, an honor student and a talented artist. She loved deeply, laughed loudly and possessed a presence that people remembered.

Morgan was not a symbol. She was not a diagnosis. She was a daughter, my daughter, a sister, granddaughter and friend. She could be funny, stubborn, generous, exasperating and fiercely loyal. She had the ability to walk into a room and alter its atmosphere.

She also lived with an eating disorder for over seven years.

On October 30, 2016, Morgan died at the age of twenty-three. People who loved her were in the hospital that dark night. But love alone does not overcome an illness that had taken control of her body and mind.

No parent is ever prepared for that moment. There is no training for walking out of a room after your beloved child draws her last breath. No language can adequately describe the silence that follows. The world continues, even when your own world has stopped.

For a time, I did not know what I would do with the grief. No parent ever does. I only knew that I could not allow Morgan’s life to be reduced to the manner of her death.

After she was gone, people who had known her during treatment began telling me stories. They remembered how Morgan encouraged them, challenged them and tried to help them keep fighting. Even while she was struggling, she saw the pain in others.

One sentence from her journals has remained with me, “I can help everyone else, I just can’t seem to save myself.”

Those words broke my heart. Eventually, they also gave me direction.

If Morgan could no longer help the people she met in treatment, perhaps I could continue that work for her. I was a trial lawyer. I understood how to investigate, question institutions, examine evidence and demand answers. I knew almost nothing, however, about the scientific, clinical and commercial systems surrounding eating disorder treatment.

So, I began learning. After Morgan’s death, I spoke publicly about eating disorders and the devastation they can bring to patients and families. I spoke with patients, parents, clinicians, researchers, lawyers, advocates and survivors. With every conversation, I understood more clearly how unprepared many families are when an eating disorder enters their home. I also came to see how often the medical system fails to recognize the illness, particularly when a patient does not conform to the narrow image many people still associate with anorexia or another eating disorder.

Some patients are told they do not look sick. Others are congratulated for weight loss while their physical condition deteriorates. Dangerous symptoms are dismissed, misunderstood or attributed to something else. Families are left searching for specialists during a medical emergency, often while insurers debate whether treatment is necessary.

The consequences can be catastrophic.

I began using my legal training to help patients and families challenge insurers, treatment providers and organizations with power over the eating disorder community.

Advocacy is easy when it requires only agreeable statements and ceremonial support. It becomes more difficult when the facts demand uncomfortable questions. Who benefits from the present system? Who is accountable when treatment fails? Why are families so often required to become investigators, medical researchers and insurance experts while trying to keep someone alive?

There are people working in this field who are dedicated, compassionate and courageous. Yet good intentions cannot substitute for evidence, competence or accountability. Patients deserve more than sympathy. They deserve a system capable of recognizing illness early, providing effective treatment and learning honestly from failure.

Morgan deserved that system.

So do the people fighting for their lives today.

Over the years, I have met extraordinary individuals whose lives were nearly lost to eating disorders. Some recovered after being told there was little hope. Others survived medical crises that should have been recognized sooner. Parents have contacted me from hospitals, treatment centers and homes filled with fear. Survivors have shared experiences they had never previously spoken about.

Their stories have strengthened my belief that hopelessness must never become the organizing principle of eating disorder care.

I remain convinced that recovery is possible, even when the path is long, arduous and uncertain. Hope is not a sentimental slogan. It requires trained physicians, informed families, competent treatment, rigorous science and institutions willing to place patient welfare ahead of reputation, convenience or profit.

That is why Morgan’s 33rd birthday is not only a day of remembrance for me. It is also a day to look ahead.

In January 2027, the Texas Legislature will convene. I am working to have the Morgan Dunn Eating Disorders Education Act introduced during that session.

The proposed legislation would require medical schools in Texas to provide meaningful core instruction on eating disorders. Future physicians would learn to recognize warning signs, understand medical complications, identify refeeding risks, avoid diagnostic bias and make appropriate referrals. They would also be taught that a person can be gravely ill at any body size and that reliance on appearance or body mass index can delay lifesaving care.

The requirement would not be enormous. Eight hours of focused education and a case-based competency assessment cannot solve every problem in eating disorder treatment.

It could, however, change what happens in an examination room.

A physician might recognize the illness earlier. A patient might be taken seriously before reaching medical collapse. A parent might receive guidance instead of dismissal. Someone whose symptoms do not fit a stereotype might be properly evaluated and referred for treatment.

That single encounter could alter the course of a life.

I cannot give Morgan the years she should have had. I cannot watch her turn 33, build a career, create more art, fall in love or discover the person she would have become. Grief never releases a parent from those thoughts.

What I can do instead is continue the work her life placed before me. I cannot rewrite the ending of her story. But I can help ensure that her compassion continues to reach people she never met.

When the Morgan Dunn Act becomes law, every physician who learns to recognize an eating disorder will become part of her legacy. Every patient who receives earlier care will give her life further meaning. Every family spared even a portion of the confusion and fear we experienced will remind me why this work must and will continue.

Today, I celebrate Morgan as she lived … intelligent, creative, funny, courageous, complicated, loving and unforgettable. I remember her smile, her voice and the energy she brought into every room. I remain grateful for the 23 years that were far too few. But they were years filled with more love than death can erase.

Happy 33rd birthday my beloved Morgan. Today, I will laugh. I will cry. I will remember. And your strength and courage will continue to guide this journey.

I cannot place a present in your hands this year. Instead, I will carry your name to the Texas Capitol.

The Morgan Dunn Eating Disorders Education Act is my birthday present to you. And your incredible spirit will carry on and be noted by the number of lives saved.

An advocacy movement that presents itself as devoted to saving lives must answer a basic question: Are its priorities organized around the patients most likely to die, or around the talking points its leaders most prefer to promote?

With regard to the eating disorder community, the public record points toward a disturbing answer.

Several AI research platforms were utilized to conduct a studied analysis. These programs concluded when measured by organizational messaging, conference programming, certification curricula, activist intensity and public visibility, the modern eating disorder hierarchy appears to be:

1. Social justice
2. Obesity and opposition to obesity medicine
3. Binge eating disorder
4. Anorexia nervosa
5. ARFID
6. Bulimia nervosa

Now let’s compare that hierarchy with mortality rates.

A comprehensive 2025 meta-analysis found that people with anorexia nervosa died at 5.21 times the expected rate of comparable members of the general population. The standardized mortality ratio for bulimia nervosa was 2.20. For binge eating disorder, it was 1.46, based on a smaller body of evidence.

A separate meta-analysis involving more than 33,000 anorexia patients reached nearly the same conclusion: an estimated mortality ratio of 5.06. Suicide accounted for approximately 21% of reported deaths. Cardiac causes accounted for another 19%.

Translated into ordinary language:

Anorexia ranks first in mortality but fourth in public priority. Bulimia ranks second in mortality but last in visibility.

That is not a minor imbalance. It is an indictment.

The Deadliest Diagnosis No Longer Sets the Agenda

Anorexia nervosa can damage the heart, brain, endocrine system, bones and nearly every major organ. It can impair insight, intensify compulsive behavior and convince desperately ill patients that the treatment required to save them is the very thing they must resist.

Yet anorexia does not determine the public identity of the eating disorder movement.

The field still acknowledges anorexia. Organizations maintain information pages. Treatment centers advertise programs. Some researchers continue to study it. But recognition is not priority.

Priority produces sustained campaigns for physician education, early diagnosis, medical stabilization, insurance reform, reliable outcome reporting and protection against premature discharge. It produces outrage when patients deteriorate inside a fragmented treatment system that cannot establish consistent standards or demonstrate long-term success.

Instead, most visible campaign movements in the eating disorder community increasingly center on identity, inclusion, body liberation, weight stigma and social justice. Those concerns may deserve attention. But they do not justify allowing the eating disorder with the greatest mortality burden to become institutionally secondary.

A field confronting one of psychiatry’s deadliest illnesses should not have to be reminded that preventing death is not merely one item on an inclusion agenda. It is the central obligation and highest priority.

The Legislative Record Confirms the Priority Shift

The legislative agenda makes the disparity unmistakable. Approximately 45% of the identifiable pending legislative proposals in the eating disorder sphere concern diet pills, weight-loss supplements, obesity treatment, or opposition to weight-focused practices. Legislators are being asked to regulate supplement sales, restrict minors’ access to diet products, expand coverage for obesity medications, and address weight-based policies.

There is no comparable legislative urgency surrounding anorexia research. Currently, there are no pending federal or state bills specifically directed toward anorexia mortality, medical stabilization, treatment effectiveness, relapse, long-term survival, or the biological consequences of starvation.

The contrast exposes the movement’s priorities. Diet pills and obesity generate repeated bills, organized campaigns, and sustained advocacy. The eating disorder carrying more than five times the expected mortality has no research bill of its own.

A movement cannot credibly claim that saving lives remains its highest obligation when it mobilizes legislators around diet products and weight terminology while failing to demand research into why anorexia patients continue to die.

The absence of anorexia research legislation is not an isolated omission. It is the legislative expression of the same hierarchy visible in conferences, certification programs, public campaigns, and organizational messaging. The subjects most compatible with the movement’s current ideology receive political action. The deadliest diagnosis receives little, if any acknowledgment at all.

Bulimia Has Been Allowed to Disappear

The treatment of bulimia nervosa provides the clearest evidence that mortality no longer drives institutional attention. Bulimia carries more than twice the expected mortality of the general population. Recurrent purging can cause severe electrolyte disturbances, cardiac arrhythmias, kidney damage, gastrointestinal injuries and increased suicide risk.

Yet bulimia occupies the bottom of the visibility ranking.

It has no dominant national campaign, no expanding certification industry, no powerful activist constituency and no comparable annual awareness infrastructure. It is commonly reduced to a general information page, an occasional recovery story or a passing reference to “bingeing and purging.”

The reason is difficult to ignore. Bulimia offers little ideological or institutional utility. It is not new enough to generate the professional excitement surrounding ARFID. It is not as closely connected to higher-weight activism as binge eating disorder. It does not support the same body-liberation narrative or social-media branding opportunities. As a result, a diagnosis carrying the second-highest demonstrated mortality among the major eating disorders has been permitted to drift toward the edge of public concern.

That is not evidence-based triage. It is institutional neglect.

Binge Eating Disorder Receives an Ideological Multiplier

Certainly, binge eating disorder deserves attention. It is prevalent, disabling and frequently underdiagnosed. Patients deserve effective care and protection from stigma. However, a mortality rate comparison does not explain why it receives greater institutional priority than anorexia or bulimia.

Its estimated mortality ratio of 1.46 is elevated but substantially lower than the estimates for anorexia and bulimia. Its institutional advantage must come from somewhere else.

BED aligns closely with the eating disorder community movement’s dominant emphasis on higher-weight patients, diet culture, weight stigma, fatphobia, intentional weight loss and opposition to conventional obesity treatment. Advocacy for BED therefore functions simultaneously as diagnosis education, social-justice messaging and resistance to weight-centered medicine.

That alignment does not make BED unimportant. It does explain why BED receives an institutional multiplier that mortality alone would not provide. The problem is not that BED receives attention. The problem is that more lethal diagnoses receive less.

Obesity Has Become More Visible Than Anorexia Mortality

Obesity is among the most intensely discussed subjects in the eating disorder community. So intensely that activists, organizations and treatment providers frequently spell it “ob*sity,” as though the medical word itself requires censorship.

Organizations publish articles declaring the term fatphobic. Treatment companies question the existence of an “obesity epidemic.” Activists challenge BMI, intentional weight loss, pediatric obesity treatment, bariatric surgery and GLP-1 medications. Conference sessions and professional discussions increasingly treat obesity medicine as a source of oppression rather than a response to a legitimate health issue. This is not peripheral commentary. It represents enormous institutional attention.

There is no dispute that weight stigma can cause harm. Larger bodied patients can be dismissed, humiliated or misdiagnosed. Body size alone cannot determine an individual’s health. None of that justifies creating a professional culture in which the word “obesity” is treated as more dangerous than the medical burden it describes.

When organizations devote greater energy to censoring the term than to confronting the deaths associated with anorexia and bulimia, the priority problem becomes impossible to dismiss.

Social Justice Has Become the Driving Force

In some context, social justice belongs in eating disorder care. Race, poverty, disability, gender, insurance barriers and unequal access can determine who receives treatment and who is abandoned.

Social justice should strengthen the effort to save lives, not displace the obligation to demonstrate that patients are suffering and dying.

New certification programs increasingly market themselves around anti-racism, cultural humility, body liberation, weight inclusivity, intersectionality, oppression and white supremacy culture. These programs seek to define what clinicians should learn, which values should govern treatment and how professional authority should be exercised. Their public emphasis reveals what they believe will attract clinicians, confer legitimacy and shape the next generation of eating disorder professionals.

The question is not whether cultural competence belongs in clinical education. The question is why anorexia mortality, medical stabilization, impaired judgment, physician training and the risk of premature death do not receive comparable prominence.

A profession allegedly dedicated to saving lives should organize education around the dangers most likely to kill patients. Cultural competence should improve the delivery of that care. It should not become the principal product while mortality prevention is reduced to another module. When a certification program can devote extensive attention to white supremacy culture while the deadliest eating disorder ranks fourth in public priority, ideology has displaced triage.

“Terminal Anorexia” Exposed the Entire Hierarchy

The “Terminal Anorexia” controversy should have forced the field to confront its priorities. Anorexia, the eating disorder with the highest established mortality was the sole diagnosis selected for a proposal under which certain patients might be declared terminal and where legally available, qualify for medical aid in dying. Critics warned that prognosis could not be determined reliably, starvation could impair judgment and a terminal label could convert inadequate treatment into a death sentence.

That proposal should have generated immediate institutional mobilization. Organizations that rapidly condemn stigmatizing language should have mobilized against declaring anorexia patients beyond recovery. Certification programs should have convened emergency discussions. Advocates committed to disability justice, healthcare equity and protection from institutional abandonment should have demanded proof before any malnourished patient was classified as terminal.

That movement wide mobilization did not occur. Silence was the order of the day.

The contrast is devastating. Parts of the field treated the spelling of obesity as an urgent moral issue while remaining publicly silent when the deadliest eating disorder was offered as a basis for medically facilitated death.

That is misplaced priority carried to its final, fatal conclusion.

The Usual Defense Fails

The predictable defense is that public health priorities cannot be based solely on mortality.

Although that may be technically true it is also both reductive and evasive.

Mortality is not the only legitimate measure of public health importance. Prevalence, disability, delayed diagnosis, unequal access, discrimination, and long-term impairment all deserve attention. But acknowledging those considerations does not permit mortality to become an afterthought. When one diagnosis carries more than five times the expected risk of death, and another more than twice the expected risk, those facts alone should exert decisive influence over institutional priorities. A movement may weigh many forms of harm, but it cannot credibly claim to be organized around saving lives while consistently assigning greater visibility, funding, advocacy, and professional attention to issues carrying substantially less immediate lethal risk. Mortality always imposes a minimum level of urgency.

Organizations cannot evade responsibility by treating their priorities as accidental. Institutions reveal their priorities through allocation. Conference agendas, certification curricula, public campaigns, grants, legislative initiatives, staffing decisions, and fundraising appeals all reflect deliberate institutional choices. When the same subjects repeatedly receive the most prominent platforms, the greatest rhetorical urgency, and the strongest organizational support, while mortality prevention, physician education, medical stabilization, insurance reform, and treatment accountability remain comparatively neglected, the resulting hierarchy is not incidental. And matters of integrity and transparency must then be questioned and explored.

The answer to those questions may lie in the ideological culture of the organizations themselves. When boards, executives, policy officers, conference speakers, educational programs, and campaigns repeatedly reflect the same social justice framework, institutional homogeneity becomes relevant. A movement lacking meaningful dissent can mistake agreement within its own leadership circle for agreement among patients, families, clinicians, and the broader public.

It is the product of judgment, and the institutions making those judgments are responsible for what they elevate and what they leave behind. When institutions repeatedly choose social justice branding, obesity language controversies and weight stigma messaging over physician education, medical stabilization, mortality reporting, insurance reform and enforceable treatment standards, they are not expanding the mission.

They are replacing it.

The Verdict

The mortality evidence exposes a movement whose public priorities are no longer organized primarily around lethality.

Anorexia is first in mortality and fourth in visibility. Bulimia is second in mortality and sixth in visibility. Binge eating disorder receives greater institutional energy despite a lower demonstrated mortality ratio. Obesity commands enormous attention, but much of that attention is directed toward delegitimizing the diagnosis and opposing its treatment. Social justice has risen above every clinical condition as the movement’s dominant public identity.

That hierarchy cannot be defended as clinical triage.

It reflects ideological priority, activist pressure, branding opportunity and institutional self-interest more closely than it reflects the risk that patients will die. A serious eating disorder movement should be capable of broadening representation without obscuring mortality, opposing discrimination without denying disease and practicing cultural humility without surrendering medical judgment.

The present eating disorder hierarchy does the opposite.

When organizations turn obesity into a forbidden word but cannot turn anorexia mortality into a defining national campaign, they have revealed their priorities. When bulimia carries more than twice the expected mortality and remains the least visible major diagnosis, they have revealed them again. When certification programs institutionalize ideology while mortality prevention lacks comparable prominence, the conclusion becomes unavoidable and inescapable.

This is not merely a movement with misplaced priorities. It is a movement that has constructed a hierarchy in which ideological usefulness outranks mortality, institutional branding outranks medical danger, and the patients facing the greatest risk of death receive the least sustained urgency. The consequence is not a rhetorical imbalance or an academic disagreement. It is institutional abandonment.

When an eating disorder community gives greater priority to the issues identified as the most convenient to promote rather than to the patients most likely to die, it has forfeited any credible claim that saving lives remains its highest obligation.

Eating Disorder Hope (“EDHope”) began as an independently operated educational website. Over time, it built credibility by publishing information about eating disorders and recovery, maintaining treatment directories and state and city provider pages, offering screening resources, and helping families identify possible sources of care.

That history gave the website something a new treatment company could not create overnight. That is, public trust, extensive searchable content, established Google visibility, and access to families actively looking for help.

Ownership and control of that platform changed in June 2026.

On June 30, Within Health announced that Hopeful Media, LLC, the operator of EDHope and The Bulimia Project, had become part of the Within Health organization. EDHope’s owner is now identified as Hopeful Media, LLC which is a wholly owned subsidiary of Within Health Group, Inc. Within Health is the brand name. Within Health Group, Inc. is the full corporate name identified by EDHope. The word “Within” by itself, has no particular significance.

Within Health is a for profit virtual eating disorder treatment company. EDHope, the educational website that spent years earning the public’s confidence is now owned and controlled by one of the virtual businesses competing for eating disorder patients.

The acquisition did not simply give Within Health another place to advertise. It gave the company access to families before they select a provider, before they understand the available levels of care, or before they recognize that the information presented to them might be shaped by a commercial interest which has only been in business since 2021. And does not see patients face-to-face.

From Education to Patient Acquisition

EDHope openly and notoriously continues to portray itself as an independent resource connecting families with treatment providers without favoring any particular program. Yet the contact number prominently advertised on its website routes callers directly to Within Health, the virtual treatment company that owns and controls EDHope.

That relationship is not disclosed beside the number in clear, prominent language. A visitor must instead notice and click the italicized phrase “*About Our Number,” which appears in small print beneath the telephone number. Those three words are inconspicuous on the page. Other hyperlinks are underlined, displayed in contrasting colors, or otherwise formatted to attract attention. The ownership related disclosure is not.

This ownership related disclosure is also hidden on another part of the EDHope’s homepage. EDHope merely states it is, “powered by Within.” Not owned, but powered by. Not Within Health. Just Within. Apparently, Within Health cannot even be completely transparent about its ownership of EDHope.

Only after the visitor opens the pop up does EDHope acknowledge the routing arrangement. Even then, the disclosure emphasizes that EDHope does not receive a commission based on the provider ultimately selected. That statement may sound reassuring, but it sidesteps the central financial conflict.

Within Health has no reason to pay a referral commission to its own corporate affiliate. When an EDHope caller enters treatment with Within Health, the economic benefit does not take the form of a commission. It arrives as treatment revenue generated by the patient’s admission.

The absence of a commission therefore does not eliminate the conflict. It merely describes the corporate arrangement in terms that obscure how the money is actually made.

Consider also more often than not, the person coming to the EDHope website is a frightened parent whose child may be suffering from a serious eating disorder and who is urgently trying to understand the illness, compare treatment options, and find help. EDHope expressly addresses families and loved ones, acknowledges that the treatment process can feel overwhelming, and invites visitors who do not know where to begin to call its advertised number. In those circumstances, a reasonable parent is likely to rely upon the website’s repeated assurances that EDHope is an independent, unbiased guide … and not stop to examine footer disclaimers, open inconspicuous hyperlinks, or trace the corporate ownership of Hopeful Media, LLC.

These companies do not publicly report how many calls become Within Health assessments, how many result in admissions, or how frequently callers are referred to competing inpatient, residential, or partial hospitalization programs. Without those figures, the public cannot determine whether the hotline functions as a neutral navigation service or as an admissions pipeline built upon the credibility EDHope developed before Within Health took control.

The distinction is especially important because Within Health only provides virtual treatment. Families calling an apparently independent resource should know whether they are receiving an objective assessment of every appropriate level of care or entering the admissions department of a virtual company selling one particular model.

A Marketplace Owned by One of Its Competitors

EDHope sells preferred directory visibility to treatment providers. Paying companies can appear above free listings, purchase premium placement, and obtain greater exposure across virtual, state, city, homepage, and other website locations.

This platform openly defines its users as a high-intent audience. In practical terms, this audience are families actively deciding where to obtain treatment and how to spend substantial amounts of money.

Competing providers are therefore being asked to purchase visibility inside a marketplace owned and manipulated by Within Health. Even after paying, no competitor can obtain the advantages Within Health already possesses through ownership of the website, access to its total audience, receipt of its treatment calls, and potential knowledge of the searches and provider pages attracting consumers.

Within Health is also identified as EDHope’s Platinum Sponsor. That description makes Within Health sound like an outside advertiser supporting an independent publication, even though its wholly owned subsidiary operates the publication.

The owner is not merely buying space inside the marketplace. The owner controls the marketplace itself.

The Owner Declares Itself Superior

EDHope’s sponsorship page describes Within Health’s treatment as “clinically superior” and “revolutionary.” Those phrases appear on a website that continues to present itself as an independent source of treatment information.

“Clinically superior” is not harmless puffery. It is a comparative medical claim suggesting that Within Health produces better clinical results than competing treatment approaches.

The advertisement does not identify the programs being compared, the outcomes measured, the patient population studied, the methodology used, or any independent research supporting the claim. Within Health may possess such evidence, but none is provided beside the assertion.

The conflict of interest and ethical questions are difficult to ignore. A virtual treatment company controls the website, appears as its highest-level sponsor, and uses the platform to declare its own services clinically superior.

Paid Placement Disguised as Distinction

EDHope uses the heading “Top Virtual Eating Disorder Centers” above a tier containing sponsored providers. Its advertising materials separately confirm that payment buys placement above free listings and that premium payment can secure top positioning.

The word “Sponsored” appears beside the paid providers, but the heading still communicates a broader message. A family may reasonably interpret “Top” to mean that the programs were selected because of superior outcomes, safety, experience, or independent clinical review. The public materials disclose no such ranking methodology. What they do establish is that money materially influences prominence.

A sponsored provider has purchased attention. A top provider is generally understood to have earned distinction. EDHope blurs that difference while placing its own corporate owner inside the preferred tier.

And the money continues to flow into the same interconnected network. Providers may purchase premium placement on EDHope, but callers using the website’s general treatment number are delivered first to Within Health. When a caller needs in-person care that Within Health cannot provide, the most obvious referral destination is Galen Hope, the South Florida treatment center founded and still led by Within Health’s own co-founder, chief executive officer, and chief medical officer, Dr. Wendy Oliver-Pyatt.

Within Health and Galen Hope do not publicly disclose whether Galen Hope receives preferential referrals, what instructions are given to admissions personnel, or how often callers are directed there rather than to unaffiliated competitors. It would strain credulity to assume that these overlapping leadership, clinical, and commercial relationships play no role in the referral process. That does not establish the answer. It does establish why the FTC should obtain the call scripts, referral logs, internal communications, financial arrangements, and admissions data necessary to find it.

Competitors Vanish While Their Names Remain

EDHope’s provider directory is not comprehensive. Major treatment organizations have been excluded from relevant searches, substantially underrepresented, or connected to pages containing little or no useful information.

Eating Recovery Center operates a large Dallas based program offering inpatient, residential, partial hospitalization, and intensive outpatient treatment. Yet EDHope’s Dallas results have prominently displayed sponsored Center for Discovery locations while failing to present ERC Dallas as a functioning local option. ED Hope nevertheless maintains an indexed page using the name “Eating Recovery Center Dallas.” But this page contains no meaningful provider name, address, telephone number, description, or treatment information.

Children’s Hospital of Plano which has a dedicated eating disorder treatment program for children and adolescents is also absent from EDHope’s Texas treatment centers.

Center for Change also had an indexed page bearing its name but no usable listing. An obsolete Veritas Collaborative page remains searchable even after that brand had been retired and consolidated under The Emily Program.

These pages may be the result of neglect, faulty migration, outdated databases, or deliberate commercial strategy. The public record does not yet establish which explanation is correct. Their practical effect is easier to identify. A consumer searching for a particular treatment provider can enter a Within Health owned website, encounter paid listings and Within Health advertising, and receive an invitation to call Within Health, while the organization originally sought is nowhere meaningfully presented.

When questionable health claims are being made and families are potentially hurt, the ramifications are serious.  As should be the consequences.

The Partner Who Understood the Internet

Within Health’s digital strategy becomes easier to understand when its leadership is examined. The company’s co-founder and president, Abhilash Patel, publicly describes himself as a digital marketer, entrepreneur, and venture investor.

His Within Health biography states that he founded Ranklab, a marketing company that worked with behavioral health operators, and co-founded Recovery Brands, the digital publisher associated with Rehabs.com and Recovery.org. Patel’s experience lies precisely at the intersection of behavioral health, internet publishing, search visibility, and patient acquisition.

That background does not prove that Patel created the empty competitor pages or directed deceptive advertising. It does establish that Within Health was co-founded by an executive who understood the commercial value of controlling the websites families encounter before choosing treatment.

EDHope is far more than a collection of educational articles. It functions as a powerful patient acquisition channel, intercepting consumers who are searching for specific eating disorder treatment programs and instead, directs them first to an EDHope controlled page. Across numerous Google searches, EDHope appears as the first organic result, often outranking the treatment provider’s own website. The following searches illustrate the pattern:

Iaedp eating disorders

AED eating disorders

Veritas eating disorders

Center for Change eating disorders

Monte Nido eating disorders

Center for Discovery eating disorders

Odyssey eating disorders

Crescent Grace eating disorders

Avalon Hills eating disorders

With those searches, and many others, the result you receive is more than likely, this:

The value of the first organic search result is not theoretical. Approximately 28% of Google users click it. That visibility gives EDHope access to consumers at the precise moment they are searching for treatment. Because Within Health operates a virtual treatment program and shares founding leadership and executive control with Galen Hope, an in person provider, EDHope functions as the front door to an affiliated treatment network. Each caller or website visitor is therefore more than a reader seeking information. That person is a prospective patient capable of generating significant treatment revenue.

The Certification Operation Completes the Network

The Within Health system now extends beyond treatment, media, and referrals. The Eating Disorders Education Institute is developing and issuing the Eating Disorders Certified Specialist (“EDCS”) designated credential.

Within Health executives and clinical leaders teach through the institute. Their instructor pages already display the EDCS credential after multiple names, even though the institute’s public materials identify September 2026 as its official launch.

A legitimate pilot program or faculty credentialing process may explain that timing. The institute has not publicly provided enough information to determine who established the standards, who independently evaluated the first recipients, or whether affiliated personnel received special pathways.

The broader conflict is more significant. A treatment network can now participate in educating clinicians, define professional standards, award credentials, and employ some of the people displaying those credentials.

Without independent governance and transparent validation, the process becomes circular. Affiliated individuals create the standards, teach the curriculum, award the credential, and then use the resulting designation to strengthen the authority of affiliated treatment services.

Peeling Back the Layers

On the surface, the organizations initially appear separate. Within Health provides virtual treatment, Hopeful Media operates websites, EDHope publishes information and directories, EDEI provides professional education and certification, and Galen Hope provides in-patient treatment services.

However, if we follow the leadership, one person connects every major component.

Dr. Wendy Oliver-Pyatt is Within Health’s co-founder, chief executive officer, and chief medical officer.

The Eating Disorders Education Institute is the public-facing educational operation of Institute for Contemporary Eating Disorder Education, LLC, a Florida for profit LLC owned and controlled by Dr. Wendy Oliver-Pyatt, its only publicly identified authorized member.

Galen Hope is a privately held, for profit treatment company operated through Galen Hope Holdings, LLC. It was founded and originally owned by Dr. Oliver-Pyatt and Amy Boyers. Dr. Oliver-Pyatt is listed on the entity’s website as its CEO and Founder.

Within Health’s subsidiary, Hopeful Media, LLC controls EDHope. EDHope promotes Within Health, routes treatment calls to Within Health, and describes Within Health’s services as clinically superior. Current Within Health personnel teach through Dr. Oliver-Pyatt’s certification institute.

Patel provides the digital marketing and behavioral health publishing experience. Dr. Oliver-Pyatt supplies the medical authority, executive control, treatment operations, and certification enterprise.

Together, they sit at the center of a network syndicate capable of influencing what families read, which providers they find, whom they call, and which professionals appear qualified to treat them.

An Investigation Is No Longer Optional

This structure may ultimately prove to be aggressive but lawful vertical integration. It also may instead represent one of the most concentrated and conflicted commercial systems in the eating disorder field.

The conduct described above raises several potential violations of Section 5 of the Federal Trade Commission Act which prohibits unfair or deceptive acts or practices in commerce.

Despite its ownership by Within Health and the routing of its general treatment telephone number to Within Health, EDHope’s continued representation as an “independent and unbiased educational resource” may create a materially misleading impression about the commercial source and purpose of the information families receive.

The FTC expressly recognizes that promotional content may be deceptive when it appears to originate from an independent or impartial source, even when some underlying statements are technically accurate. Similarly, placing paying providers beneath a heading such as “Top Virtual Eating Disorder Centers” may falsely imply that prominence was earned through objective clinical evaluation rather than purchased through sponsorship.

Within Health’s description of its treatment as “clinically superior” presents an additional issue because an objective comparative health claim must be supported before publication by competent and reliable scientific evidence relevant to the precise comparison being asserted. Disclosures that the website is “powered by” Within Health, that certain listings are sponsored, or that calls are directed to Within Health will not necessarily cure these representations if the disclosures are inconspicuous, separated from the claims, or overwhelmed by the website’s broader portrayal of independence.

The FTC evaluates the entire net impression conveyed to a reasonable consumer, making the ownership relationship, paid rankings, treatment-call routing, and asserted clinical superiority appropriate subjects for investigation as possible deceptive misrepresentations, material omissions, and inadequately substantiated health advertising.

The FTC will be asked to investigate those matters as well as the claims of independence, the routing and conversion of treatment calls, the assertion of clinical superiority, the paid provider rankings, the use of competitor-name pages, the handling of consumer search and health-related data, and the relationships among Within Health, Hopeful Media, Eating Disorder Hope, Galen Hope, and the Eating Disorders Education Institute.

The central question is no longer whether each company performs some legitimate function. The question is whether those functions have been assembled into a coordinated system that converts public trust, internet visibility, professional authority, and consumer vulnerability into an unfair and unethical commercial advantage.

Families have a right to believe they are entering an independent educational resource. If instead, they are entering into a privately controlled treatment network hiding behind the reputation of a website built before that network owned it, there should be draconian consequences for this misconduct.

Dr. Oliver-Pyatt and the executives surrounding these enterprises are now on notice. The ownership records, leadership overlaps, paid rankings, comparative clinical claims, treatment-call routing, competitor-name pages, and prematurely displayed credentials have been identified and are subject to subpoena.

The remaining questions cannot be answered through carefully drafted website disclosures or assurances of editorial independence. They require the underlying call scripts, referral logs, admissions data, internal communications, credentialing records, financial relationships, and instructions given to employees who are contacted by families seeking treatment.

Presumably, the Federal Trade Commission and other appropriate agencies who may conduct investigations will be requesting those records. Perhaps only then will truthful answers be forthcoming from the syndicate of Within Health, Galen Hope, Hopeful Media, EDHop, Eating Disorders Education Institute and Dr. Wendy Oliver-Pyatt.

The eating disorder field urgently needs better professional education. Physicians, nurses, therapists, and dietitians may complete years of training without learning how to recognize malnutrition, assess medical instability, identify refeeding risk, distinguish among diagnoses, or determine when outpatient treatment has become unsafe.

The Eating Disorders Education Institute (“EDEI”) is the latest entity attempting to provide this education by claiming its program would build bridges. Instead, it merely created yet another silo pandering to a certain aspect of the eating disorder spectrum.

The EDEI was created by Chevese Turner and Dr. Wendy Oliver-Pyatt. The EDEI purportedly offers courses in assessment, medical complications, psychological treatment, nutrition, trauma, cultural awareness, weight stigma, body liberation, and social justice. It also plans to award a new Eating Disorders Certified Specialist credential known as EDCS.

The question is not whether additional education would benefit clinicians. The question is why the field needed another privately controlled, for profit credential, particularly one that places social justice and body liberation so prominently within its definition of professional competence.

An unproven credential marketed as a new standard

EDEI describes itself as a leading certification program. This despite the fact that its first public cohort is not scheduled to begin until September 2026. The credential therefore has no record of graduates, examination performance, employer acceptance, disciplinary enforcement, or improved patient outcomes.

New programs must first be required to prove themselves. They cannot credibly market anticipated success as an established accomplishment.

Even the current public materials of this “institute” (which really is not an institute at all) provide inconsistent descriptions of what candidates must complete. Different pages refer to varying numbers of courses and either eighteen or twenty-four practicum hours. Those discrepancies may be prelaunch mistakes, but they concern the essential requirements of a credential already being promoted as evidence of specialization and clinical readiness. They also evidence haste and lack of thorough professionalism.

A certification body must be able to state clearly how many courses are required, how much supervised experience candidates must obtain, what knowledge is tested, and what the designation actually certifies. The EDEI fails on these issues.

Social justice is not merely included; it is embedded

EDEI’s curriculum contains legitimate clinical subjects, including assessment, medical complications, psychological treatment, nutrition, trauma, and ethics. Topics which are covered by other programs. It would be inaccurate to describe the EDEI as nothing more than social activism.

Yet a number of core courses expressly emphasize cultural awareness, weight stigma, body liberation, social justice, and culturally responsive care. EDEI also states that weight inclusivity, anti-bias practice, cultural humility, and diverse lived experience will be integrated throughout the program.

Some of that instruction is necessary. Clinicians often miss eating disorders in people who do not appear underweight, and patients in larger bodies can suffer severe restriction, malnutrition, and medical instability. Cultural and economic barriers can also prevent people from obtaining accurate diagnoses and treatment.

The difficulty arises when broad political or philosophical concepts are treated as settled clinical competencies. Body liberation and social justice are not medical diagnoses, treatment protocols, or measurable safety standards. EDEI must clearly distinguish among replicated research, clinical guidelines, expert opinion, lived experience, and advocacy doctrine.

Lived experience can reveal mistreatment and diagnostic blind spots. But it does not carry the same evidentiary weight as validated clinical research, particularly when patients with the same diagnosis may hold sharply conflicting views about treatment.

And most importantly, instead of simply illuminating these issues, the EDEI must provide practical, rational, logical, workable, real-life solutions addressing these issues. Without solutions to embrace and implement, illumination becomes nothing more than complaining.

Certification should measure competence, not agreement

EDEI emphasizes reflective “Confirm Understanding” exercises, while its public materials provide little detail about the final examination or competency assessment. Reflection can help students examine assumptions, but it cannot by itself establish that a clinician recognizes bradycardia, electrolyte abnormalities, orthostatic instability, prolonged QTc, suicide risk, or refeeding syndrome.

Those subjects have clinically sound and clinically dangerous answers. A specialist credential must be capable of failing an applicant who does not understand them.

The reverse is equally important. A clinician who demonstrates competence in diagnosis, medical risk, nutritional rehabilitation, family involvement, and evidence-based treatment should not be penalized because the clinician questions body liberation, HAES doctrine, or a particular interpretation of social justice.

EDEI should disclose its examination blueprint, passing standard, validation process, retesting policy, and method for evaluating reflective assignments. Candidates should also receive an explicit assurance that respectful disagreement with contested social theories will not jeopardize certification.

Otherwise, EDCS risks becoming a measure of ideological alignment and not clinical education.

Why was another credential necessary?

EDEI is not entering an empty field. iaedp already administers the Certified Eating Disorder Specialist credential, or CEDS, which requires eating disorder specific clinical experience, consultation, education, examination, and professional references.

Iaedp’s governance, financial incentives, and former membership and symposium requirements remain legitimate subjects of criticism. Those problems do not erase the fact that CEDS is an established credential with published experience requirements.

The Inclusive Eating Disorder Specialist credential, or IEDS, also recently entered the market. That program heavily emphasizes weight inclusive, trauma informed, antiracist, HAES aligned, and social justice-based education. It mentions White Supremacy Culture or WSC approximately 175 times in one module alone. It has seemingly cornered the market on social justice drum banging.

EDEI therefore does not apparently duplicate an established clinical credential. It also duplicates much of the ideological territory already claimed by IEDS.

So, what does EDCS teach or measure that CEDS and IEDS do not? Does it explore newer biologically based treatment regimens like rTMS? Does it explore the manner in which social media platforms cause harm and what can be done to minimize exposure to dangerous on-line content? Does it explore the exploding access to AI platforms and their influence on patients? Does it explore revolutionary brain implants?

What patient harm resulted from the absence of a third designation which needed to be addressed? Did Ms. Turner and Dr. Oliver-Pyatt attempt to improve, supplement, or collaborate with either existing program? Could EDEI’s courses have become an advanced concentration within an established credential? Why didn’t the ecosystem finally come together, place families first and collaborate on this important topic? This would have resulted in the production and acceptance of one, all-encompassing, strong, wide-ranging certification program which would have been authoritative, respected and the cornerstone of a stronger, collaborative community

It is reasonable to presume that EDEI will not publicly answer those questions. For that matter, will anyone else in the community?

Without a formal gap analysis or evidence of failed collaboration, EDEI appears to follow a familiar pattern within the eating disorder ecosystem: leaders identify self-perceived deficiencies in an existing organization and respond by creating another organization they can control.

A field that teaches collaboration while practicing fragmentation

Eating disorder care depends on collaboration among medicine, psychiatry, psychology, nutrition, nursing, patients, and families. A failure to communicate across those disciplines places patients in danger.

However, at the institutional level, the field repeatedly models the opposite conduct. Iaedp has CEDS. Inclusive Eating Disorder Education has IEDS. EDEI is introducing EDCS and its own consultant pathway. With no oversight and no federal or state agency which can impose accountability and consequences, silo mentality has become the inevitable result. The cost for this short sightedness is measured in human lives taken.

Each organization controls its curriculum, eligibility requirements, assessments, instructors, directories, badges, renewal fees, and professional network. No independent national body determines whether the credentials are equivalent, complementary, redundant, or incompatible. This proliferation does not create a common understanding of eating disorders. It allows clinicians to select the credential that most closely reflects their existing beliefs.

Patients and families are then left to decipher the difference between CEDS, EDCS, and IEDS. The similarity between CEDS and EDCS is especially troubling because the same four letters are merely rearranged, increasing the possibility of confusion among patients, employers, referral sources, and insurers.

Collaboration forces competing disciplines and philosophies to confront their blind spots. Separate institutions populated by generally aligned faculty can reinforce confidence without producing a more complete understanding.

The resulting fragmentation also weakens advocacy. Legislators, medical schools, licensing boards, and healthcare systems need a defensible statement of what every professional should know about eating disorders. A field divided among competing credentials and ideological definitions cannot provide that baseline with authority.

Instead of financing another badge, the ecosystem should be developing a common national competency framework that can inform medical education, graduate training, licensing requirements, and continuing education.

Closing the conversation compounds the problem

Ms. Turner and other social advocates have blocked people who disagree with them on social media. This is very troubling since it results in substantive questions being excluded from discussions used to promote professional education. Blocking critics removes contrary views from the conversation visible to followers and can create an artificial appearance of consensus. Blocking opposing points of view is not progress. To the contrary.

The question must be posed, why should a “president” of an organization which is supposed to be operating for the good of families suffering from eating disorders block anyone? How does that serve the interests of the community? As “president” of EDEI, Ms. Turner’s first and highest obligation is to the eating community at large. That includes ALL the community. Which leads to consideration of a broader issue. And that is whether that exclusion extends to clinicians, families, researchers, and advocates who question EDEI’s ideology, standards, or need for another credential. How far is she prepared to go?

A certification body should welcome rigorous examination. Scientific disagreement is not harassment, and clinical questioning is not exclusion.

EDEI could answer all concerns through transparency. Before awarding EDCS, it should publish one definitive set of course and practicum requirements, specify how much eating disorder specific experience candidates need, disclose its testing and disciplinary procedures, and explain how its founding instructors received the credential before the public launch.

The EDEI should also publish a comparison showing what EDCS adds to CEDS and IEDS, identify any attempts at collaboration, and explain why another separately controlled credential was necessary. Candidates should be told that reflective work will be judged by reasoning and evidence rather than ideological agreement.

Most importantly, EDEI should consider whether its curriculum could contribute to an independently administered national standard rather than another proprietary system. Different organizations could continue offering specialized instruction while sharing one minimum definition of eating disorder competence.

EDEI is introducing an untested designation with inconsistent public requirements, uncertain independent validation, substantial overlap with existing programs, and an unusually prominent social justice orientation. At the same time, the field continues to lack a common standard that patients, employers, medical schools, and policymakers can understand.

EDEI’s slogan is “Building Bridges, Changing Lives.” A bridge should connect existing institutions and bodies of knowledge. It should not merely lead to another separately controlled credential.

If it does not do that, EDEI is not any type of bridge.  It is simply another silo.

Alsana represents its Chief Medical Officer, Dr. Jay Joglekar, as a “leader in the eating recovery industry” who oversaw five residential, partial hospitalization and intensive outpatient programs in the Washington, D.C. region. Alsana also claims that he works with its clinical and admissions teams and “reviews each client’s pre-admission medical assessments.”

These representations are intended to convey expertise, vigilance and safety. Families deciding whether to entrust a medically compromised loved one to Alsana are expected to believe that an experienced eating disorder physician personally evaluates every prospective patient before admission.

The public record provides no reasonable basis for that belief.

A Specialist Who Exists Only in Alsana’s Biography

Alsana does not identify any of the five programs Dr. Joglekar supposedly oversaw. It names no employer, treatment center, location, period of service or formal position. The company offers no description of his responsibilities and does not even establish that the programs treated eating disorders.

That omission is glaring. Treatment programs have names, licensed facilities have addresses, and physicians who lead residential, PHP and IOP programs ordinarily leave an identifiable professional record. Yet Alsana’s entire basis for calling Dr. Joglekar an eating recovery industry leader appears to be a sentence Alsana wrote about its own employee.

Independent records describe a very different professional background. Dr. Joglekar’s Privia profile identifies him as an internal medicine physician in Winchester, Virginia who graduated from the University of West Indies Medical School. It discusses internal medicine, integrative medicine, electronic medical records and earlier work involving a clinical trial for head and neck cancer. It contains no reference to anorexia nervosa, bulimia nervosa, ARFID, medical stabilization, refeeding complications or leadership of an eating disorder program.

His Virginia Board of Medicine profile also identifies internal medicine as his area of practice. According to the most recent updates, he reported practicing internal medicine at Internal Medicine Consultants in Winchester from Monday through Friday. His profile lists no eating disorder facility, behavioral health appointment, academic position or specialized role involving eating disorders.

Public searches have identified no article written by Dr. Joglekar about eating disorders, no professional presentation, no eating disorder research project and no federal research award in the field. There is no publicly visible affiliation with the Academy for Eating Disorders nor iaedp, no documented role with NEDA and no disclosed eating disorder credential or certification.

A physician does not need to write articles, receive federal grants or join professional organizations to provide competent care. But Alsana is not merely stating that Dr. Joglekar is a licensed internist. It is presenting him as a leader in a specialized field while identifying no employment, training, clinical experience, scholarship or professional involvement that supports that description.

The cumulative absence cannot be dismissed as an incomplete résumé. Alsana supplies the conclusion while omitting every fact that could establish its truth. That is not transparency. It is credentialing by assertion.

Internal Medicine Is Not Eating Disorder Expertise

Dr. Joglekar may be a capable internist. Internal medicine training is relevant to cardiac abnormalities, electrolyte disturbances, dehydration, kidney function, endocrine complications and medication interactions. None of that, however, establishes specialized competence in evaluating patients entering a higher level of care for an eating disorder.

Such an admission is not a routine medical clearance. Patients can appear outwardly stable while facing serious cardiac, metabolic and psychiatric danger. Laboratory results may appear deceptively normal, current weight may conceal rapid deterioration, and a single set of vital signs may fail to reveal fluid manipulation, purging or the cumulative effects of severe restriction.

A meaningful review requires the physician to integrate weight trajectory, blood pressure, pulse, orthostatic changes, laboratory findings, EKG results, medications, purging, restriction, compulsive exercise, psychiatric instability and refeeding risk. The physician must also determine whether the proposed facility can safely manage the patient or whether acute medical hospitalization is required.

Nothing publicly available establishes that Dr. Joglekar has experience making those decisions in eating disorder patients. His general medical background may qualify him to read laboratory results and identify familiar abnormalities. But Alsana has shown no factual basis for portraying him as an authority on the complex and frequently deceptive medical presentation of patients entering residential treatment, PHP or IOP.

Without specialized experience, his review would necessarily depend heavily on the work of Alsana’s nurses and admissions personnel, the company’s standardized protocols and the information selected for his consideration. That is not the independent medical safeguard families are led to believe they are receiving. It is a corporate admissions process carrying a physician’s name.

What Does “Reviews Each Client” Actually Mean?

Alsana’s use of the word “reviews” conceals more than it reveals. The term could mean that Dr. Joglekar personally examines every original record, independently interprets the medical findings, evaluates the patient’s stability and determines whether the proposed placement is safe. It could just as easily describe a process in which a nurse summarizes the file, identifies selected abnormalities and obtains an electronic approval from the physician.

Those processes are not remotely equivalent. A checklist is not an individualized medical evaluation, a nursing summary is not an independent physician analysis, and an electronic signoff does not establish that the physician considered the complete clinical picture.

Alsana nevertheless uses one ambiguous word to create the impression that every prospective patient receives direct scrutiny from its highest-ranking physician. That impression reassures frightened families, strengthens confidence in the company’s admissions process and makes Alsana appear more medically rigorous than the available evidence supports.

The scale of the representation makes it even more doubtful. Alsana does not disclose its annual admission volume, but even modest assumptions reveal the physician time required for genuine individual reviews. At 750 admissions, a twenty (20) minute review would require approximately 250 hours each year; a thirty (30) minute review would require 375 hours. At 1,000 admissions, the commitment would rise to between approximately 333 and 500 hours annually.

Those figures exclude time spent obtaining missing records, requesting repeat testing, consulting with clinicians, documenting conclusions and performing Dr. Joglekar’s other duties as Chief Medical Officer. They must also be reconciled with his reported Monday through Friday internal medicine practice in which he represents to the Virginia Medical Board he devotes 100% of his time.

It is physically possible for a physician to open hundreds of electronic files. That does not mean he personally performs a substantive medical analysis of every patient, nor does it establish that he possesses the specialized experience necessary to make those reviews reliable. The more plausible inference is that Alsana’s admissions and nursing personnel perform the underlying work, with selected cases referred for some form of physician approval.

Alsana then converts that internal process into a sweeping public assurance that Dr. Joglekar reviews every prospective patient. In doing so, the company borrows the authority of his title while leaving the substance of his involvement carefully undefined.

Medical Authority Manufactured to Drive Admissions

Alsana took an internal medicine physician with no publicly documented eating disorder background and transformed him into a “leader in the eating recovery industry.” It then used his title to create the impression that every prospective patient receives individualized scrutiny from an experienced eating disorder medical authority.

The arrangement inverts the clinical hierarchy. Alsana’s frontline contract physicians and psychiatrists provide the actual patient care, (even if only virtually) and many possess direct eating disorder experience that is absent from Dr. Joglekar’s public professional record. Nevertheless, Alsana placed him at the apex of its medical structure without identifying the training, clinical history or specialized qualifications that would justify elevating his judgment above theirs. Clinicians with demonstrated experience therefore operate beneath a Chief Medical Officer whose claimed authority in the field can be traced only to Alsana’s promotional biography.

This is not merely inflated executive marketing. Alsana uses an unsubstantiated claim of specialized medical authority to reassure families deciding where to place medically compromised loved ones. By portraying Dr. Joglekar as an eating disorder leader and implying that he personally scrutinizes every admission, the company creates the appearance of a medical safeguard that the available evidence does not establish.

Physician authority has commercial value. It inspires trust, reduces fear and helps convert frightened families into admissions. Alsana wrapped that authority around a physician whose documented career is in internal medicine and whose supposed eating disorder leadership cannot be independently traced.

The white coat is real, but the specialized authority Alsana constructed around it is manufactured. And that manufactured authority is being used to sell treatment to families confronting a potentially fatal illness.

Alsana did not arrive in Birmingham as an innocent treatment provider suddenly confronted by an unpredictable act. It arrived carrying a corporate history of lax oversight, inadequate supervision, disputed treatment practices, warnings from former executives and unresolved patient safety failures at its facilities in Missouri. By the time a patient was sexually assaulted at its Birmingham residential program on July 26, 2025, Alsana had already been told, repeatedly and from multiple directions, what happens when growth, census and operational convenience overtake clinical judgment.

The assault was not the beginning of the story. It was the consequence.

Alsana may attempt to deflect and allege the attack was the unforeseen misconduct of one patient. However, evidence indicates that Alsana employees knew the offending patient had engaged in prior acts of public masturbation, sexually intrusive conduct, physical boundary violations and an escalating fixation on other vulnerable patients. Another former patient reported that the same individual sexually assaulted her and that management failed to act despite numerous prior reports. The eventual victim then warned staff directly, asked to be separated from the patient and explained that something was seriously wrong. Alsana left them together. After the sexual assault, the offending patient reportedly still remained in the program for a short period of time. Despite repeated warnings.

Reports indicate the offending patient was a private pay patient. Whether financial considerations influenced that decision is a question regulators and discovery will answer.

That sequence is the center of ongoing issues involving Alsana. Alsana sold safety, received warnings, yet failed to comply with its own safeguards and retained a patient whose conduct it was either unable or unwilling to manage. Once those facts are placed inside the company’s history, the July 2025 assault stops looking like an aberration.

Instead, it is the predictable result of the corporate system Alsana created.

The False Assurance of Safety

Residential eating disorder treatment is not housing with therapy added. Patients enter because they require an environment more structured and protective than the one they are leaving. The provider controls admissions, staffing, supervision, medical oversight, patient separation, behavioral intervention and discharge. Families entrust vulnerable loved ones because the company represents that it possesses the judgment and resources necessary to keep their loved ones safe.

Alsana continues to make precisely that representation. Its website promises a “safe, supportive space” and describes its residential program as providing structured care and support twenty-four hours a day, seven days a week. It created a marketing campaign emphasizing “Everyone deserves flowers.” The contrast is striking. While the company promoted “Everyone deserves flowers,” the allegations concerning staffing shortages, inadequate supervision, delayed intervention, and failures to protect vulnerable patients are especially troubling.

The Birmingham evidence indicates that when protection was actually required, another patient had to leave the victim during the assault and search for the only direct care employee available.

Alsana’s own staffing ratio was allegedly one direct care employee for every six patients. Seven patients were present that evening, including a patient whose known conduct demanded greater observation rather than the bare minimum. The same staffing deficiency allegedly appeared during a later physical altercation, when the sole direct care employee again had to leave the scene to obtain assistance. That repetition suggests an operating practice, not a solitary scheduling mistake.

This is where the marketing representation becomes deceptive.

Alsana advertised a controlled residential environment while staffing below its own ratio and retaining a patient whose behavior exceeded the facility’s ability to supervise. The company did not merely fail to prevent every conceivable act of misconduct. It failed to provide the protection it had promised after the specific danger was already known.

And yet, warning signs were present.

The Birmingham facility did not operate outside Alsana’s institutional history. Alsana was intertwined with Castlewood Treatment Center, whose Missouri operations generated years of controversy involving treatment practices, patient safety, supervision and institutional response. In 2022, admissions were halted at the St. Louis programs after allegations of inappropriate conduct involving direct care employees and a patient became public. This was only a few months after Alsana’s Birmingham operations opened.

In June 2022, Alsana’s former leaders also identified the corporate force driving these failures. Former CEO Jennifer Steiner testified under oath that she became concerned about Alsana’s decision to maximize growth and revenue and was then terminated and sued after refusing to support board decisions she believed would jeopardize patient care. Her exact words were: “Specifically, I became concerned with the direction of the company and what I considered to be Alsana’s decision to maximize growth and revenue above all else. When I refused to go along with certain decisions of Alsana’s Board, including decisions that I believed would jeopardize patient care, I was terminated.” 

Former Chief Clinical Officer Nicole Siegfried described growth and revenue being prioritized to the detriment of patient care, training, staff retention and culture. Other senior clinical leaders gave similar accounts.

Alsana’s former highest-ranking officers supplied more than reputational discomfort. They gave notice that weak supervision, boundary violations and an opaque response to patient complaints could cause serious harm. The Birmingham allegations involve those same categories: known inappropriate conduct, inadequate staffing, delayed intervention, fragmented authority and institutional secrecy after the event.

Alsana’s lack of transparency on its operation’s many failings extend to its very ownership.

Who owns this place?

In late 2016, The Riverside Company acquired Alsana. Press releases and social media announcements were plentiful.

These facts make it all the more perplexing when in August 2025, The Riverside Company divested itself of Alsana. There was no announcement. There were no press releases. None could be found. No buyer is identified. Alsana, whatever it is at this point, likewise failed to publicly disclose whether the transfer was an ordinary sale, a recapitalization, a lender-controlled transaction or a management acquisition.

New entities subsequently appeared. Alsana Parent Holdings, LLC, Alsana Holdings, LLC, Alsana Management, LLC, Alsana East LLC, Alsana West NorCal LLC and Alsana West – SoCal LLC. Most if not all of these entities were organized in Delaware and registered in the State of California.

However, what is curious is that none of these entities are listed with the Alabama Secretary of State and as such, are not authorized to conduct business in that state. What is also curious is that none of these entities are registered with the Alabama Department of Mental Health as a certified provider or are listed by the Alabama Department of Public Health Bureau of Health Provider Standards as a licensed facility operator.

The National Plan and Provider Enumeration System (“NPPES”) is a database managed by the Centers for Medicare & Medicaid Services (CMS) that assigns unique 10-digit National Provider Identifiers (NPIs) to healthcare providers and organizations in the United States. NPI records list Alsana Parent Holdings LLC as the parent organization for newly enumerated Alsana provider entities, including Alsana East LLC at the Birmingham address.

So, Alsana and whoever its owner and overlord is, publicly represented itself in a federal provider registry as connected to an Alabama psychiatric residential treatment facility and mental health clinic at 5101 Cyrus Circle in Birmingham. But, the Alabama Secretary of State, ADMH, and ADPH do not list them as authorized entities. Which to families seeking care and treatment should be very concerning.

Patients and regulators are entitled to know who oversee operations, appoints the board, controls staffing budgets, selects medical leadership and assumes responsibility for the liabilities inherited from Missouri and Birmingham.

Rather than provide any answers, Alsana expanded its virtual treatment program to include up to 40 states in early 2026. This should not be surprising since at least some of Alsana’s independent contractor medical doctors appeared only virtually in Birmingham. You entrust your loved one to a brick-and-mortar residential treatment center. And the medical doctor overseeing your child’s care is a mere face on a laptop monitor.  

On the other hand, Alsana did launch its “Soul Hearted” rebranding campaign, promising that patients and the eating disorder field “deserve flowers.” The campaign presented a “new beginning” without acknowledging the company’s history, former executive warnings, unresolved ownership questions or allegations of patient harm.

The flowers are not harmless silliness. They are reputation laundering through emotional imagery. Alsana is asking the public to experience the company as compassionate while withholding information necessary to judge whether it is safe.

Alsana Was Offered an Honorable Way Out

Before administrative complaints or litigation, Alsana and the responsible parties received an extensive pre-suit brochure. It explained the prior warnings, the assault, the alleged cover-up, the staffing failures, Missouri history, former executive testimony, ownership questions and physician licensure concerns.

The proposal gave Alsana a professional way to resolve the victim’s private claims. It did not demand the concealment of patient safety information, withdrawal of regulatory reports or silence concerning matters within the jurisdiction of government agencies. The victim expressly preserved her right to communicate truthfully with licensing and patient safety authorities.

Alsana could have compensated the victim, confronted the evidence and begun demonstrating that accountability would finally replace concealment. Attorneys appointed through its directors and officers insurance coverage initially engaged in discussions. They then stopped responding substantively.

Silence was their choice. But silence does not erase the evidence or prevent the next stage.

First the Regulators. Then the Courthouse.

Administrative complaints will now be filed with the Alabama Department of Mental Health, the Alabama Board of Medical Examiners and any other licensing authorities possessing jurisdiction. Those complaints will address staffing, incident reporting, patient retention, ownership disclosures, physician credentialing, telemedicine practices and whether present patients remain exposed to the same institutional failures.

Civil litigation will follow the administrative complaints. Discovery will obtain the prior reports, staffing records, private pay revenue, internal communications, Missouri investigations, Riverside’s exit, the new holding companies and every decision that left a known sexual safety risk in the residential population.

Alsana was warned in Missouri. Its former executives warned the board. Patients warned the Birmingham staff. The victim asked for protection. After the assault, Alsana was offered an honorable opportunity to resolve her private claims without buying silence from the public or the regulators.

Instead, Alsana chose concealment, flowers and silence.